title: Effects of long-term valproic acid treatment on hematological and biochemical parameters in adolescent psychiatric inpatients: a retrospective naturalistic study.
abstract: The objective of this study was to determine the long-term hematological and biochemical side effects of valproic acid (VPA) in psychiatric adolescent inpatients. A retrospective naturalistic study design was used. Participants were psychiatric inpatients treated with VPA, alone or in combination with other medications. Electronic medical files were reviewed for changes in hematological and biochemical parameters following a course of VPA treatment. One hundred and four adolescents aged 12-18 (mean 15.76±1.58) years fulfilled the study criteria. The mean blood level and duration of VPA treatment were 65.81±22.18 mcg/ml and 98.57±135.94 days, respectively. The mean levels of thyroid-stimulating hormones and triglyceride levels increased significantly from the first to the last measurement. Platelet count decreased significantly following VPA treatment. No correlation was observed between these parameters and age, duration of treatment, or VPA levels. No serious adverse events were reported. Long-term VPA treatment in adolescents with psychiatric disorders is associated with significant increases in triglyceride levels. Moreover, VPA-treated adolescent psychiatric inpatients may be at risk of developing pituitary-thyroid axis dysregulation and decreased platelet count. Therefore, baseline measurement of thyroid functions and metabolic and hematological parameters and monitoring throughout the treatment are recommended.
authors.affiliation: aDivision of Child and Adolescent Psychiatry, Geha Mental Health Center bDepartment of Psychological Medicine, Schneider Children's Medical Center of Israel cFelsenstein Medical Research Center, Petah Tikva dDepartment of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel eDepartment of Psychiatry, Divisions of Molecular Imaging and Neuropathology, Columbia University, New York, New York, USA.
authors.forename: Maya
authors.initials: M
authors.lastname: Amitai
authors.forename: Ephi
authors.initials: E
authors.lastname: Sachs
authors.forename: Amir
authors.initials: A
authors.lastname: Zivony
authors.forename: Roei
authors.initials: R
authors.lastname: Remez
authors.forename: Reut
authors.initials: R
authors.lastname: Ben Baruch
authors.forename: Ben H
authors.initials: BH
authors.lastname: Amit
authors.forename: Sefi
authors.initials: S
authors.lastname: Kronenberg
authors.forename: Alan
authors.initials: A
authors.lastname: Apter
authors.forename: Gal
authors.initials: G
authors.lastname: Shoval
authors.forename: Abraham
authors.initials: A
authors.lastname: Weizman
authors.forename: Gil
authors.initials: G
authors.lastname: Zalsman
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000187:drug effects*; D002648:Child; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D001523:Mental Disorders / Q000097:blood* / Q000188:drug therapy; D010976:Platelet Count; D012189:Retrospective Studies; D013972:Thyrotropin / Q000097:blood*; D014280:Triglycerides / Q000097:blood*; D014635:Valproic Acid / Q000008:administration & dosage* / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use
chemical_list: D014280:Triglycerides; D014635:Valproic Acid; D013972:Thyrotropin