title: Valproate Induced Hyperammonemic Delirium.
abstract: Sodium valproate induced hyperammonaemic delirium with normal liver function tests is a relatively uncommon adverse effect. It may be mistaken for psychosis or worsening of mania leading to wrong diagnosis and improper management. Plasma ammonia levels should be monitored in all patients developing altered mental status after receiving valproate therapy. This is a case series of hyperammonaemic delirium due to valproate reported to the Department of Pharmacology from Department of Psychiatry over a period of one year.
authors.affiliation: Junior Resident, Department of Pharmacology, Government TDMC , Alappuzha, Kerala, India .
authors.forename: Anupama
authors.initials: A
authors.lastname: Muraleedharan
authors.affiliation: Assistant Professor, Department of Pharmacology, Government TDMC , Alappuzha, Kerala, India .
authors.forename: Dhanya Sasidharan
authors.initials: DS
authors.lastname: Palappallil
authors.affiliation: Professor, Department of Pharmacology, Sree Mookambika Institute of Medical Science , Kulasekharam, Tamil Nadu, India .
authors.forename: Reneega
authors.initials: R
authors.lastname: Gangadhar
authors.affiliation: Junior Resident, Department of Psychiatry, Government TDMC , Alappuzha, Kerala, India .
authors.forename: Soumitra
authors.initials: S
authors.lastname: Das
keywords: Plasma ammonia; Valproate therapy
references.citation: Am J Psychiatry. 2007 Jul;164(7):1020-7
references.pmid: 17606652
references.citation: Pharmacotherapy. 2000 Oct;20(10):1216-20
references.pmid: 11034046
references.citation: Am J Med. 1993 Jul;95(1):112-3
references.pmid: 8328486
references.citation: Metab Brain Dis. 2002 Dec;17(4):367-73
references.pmid: 12602513
references.citation: Am J Psychiatry. 1997 Aug;154(8):1168-9
references.pmid: 9247410
references.citation: J Clin Psychopharmacol. 2002 Dec;22(6):631-3
references.pmid: 12454569
references.citation: Am J Psychiatry. 1988 Feb;145(2):269-70
references.pmid: 3341477
references.citation: Neurology. 1988 Mar;38(3):365-71
references.pmid: 3126407
references.citation: J Am Board Fam Med. 2007 Sep-Oct;20(5):499-502
references.pmid: 17823470
references.citation: J Urol. 1984 Nov;132(5):995-7
references.pmid: 6492293
references.citation: J Neurol Neurosurg Psychiatry. 1998 May;64(5):680-2
references.pmid: 9598692
references.citation: Chest. 2007 Oct;132(4):1368-78
references.pmid: 17934124
references.citation: J Clin Diagn Res. 2015 Apr;9(4):VD01-VD02
references.pmid: 26023626
references.citation: Ann Pharmacother. 2000 May;34(5):630-8
references.pmid: 10852092
references.citation: J Assoc Physicians India. 2004 Sep;52:746-8
references.pmid: 15839456
references.citation: Am J Psychiatry. 1995 Aug;152(8):1236-7
references.pmid: 7625483
references.citation: Indian J Psychiatry. 2008 Apr;50(2):121-3
references.pmid: 19742224
references.citation: BMC Geriatr. 2014 Jul 28;14 :87
references.pmid: 25066510
references.citation: Acta Neurol Scand. 1980 Mar;61(3):146-56
references.pmid: 7395459
references.citation: Brain Dev. 1992 May;14(3):178-81
references.pmid: 1514659