Valproic acid malabsorption in 30 year-old female patient - Case study.
OBJECTIVE
Valproic acid (VPA) is used in epilepsy treatment and as a stabilizer in bipolar affective disorder for over 40 years. Although, the pharmacokinetic properties of valproic acid are well known, it is often forgotten that the formulation of the drug significantly influences its gastrointestinal absorption.


METHODS
We are describing the case of 30 year-old female patient, diagnosed at the age of 13 with juvenile myoclonic epilepsy. Complete ineffectiveness of the treatment was caused by malabsorption of sodium valproate and valproic acid in the patient. The change of the drug formulation resulted in a several times higher bioavailability of the drug and a partial improvement of the patient's clinical condition.


CONCLUSIONS
Low concentration of valproic acid after administration the slow-released tablets are usually observed. However, a low bioavailability beside the bad compliance should be considered when the minimal level is extremely low during therapy. It is known that form of the drug, beside presence of food and its components, as well as gastrointestinal tract condition or interactions with other drugs can influence the drug level. Modification of the formulation of the drug may lead to improvement of absorption and increase its effectiveness.
Instytut Psychiatrii i Neurologii/Institute of Psychiatry and Neurology, Warsaw, Poland.
Anna
A
Jopowicz
Instytut Psychiatrii i Neurologii/Institute of Psychiatry and Neurology, Warsaw, Poland; Katedra i Zakład Farmakologii Doświadczalnej i Klinicznej WUM/Medical University of Warsaw (WUM), Department of Experimental and Clinical Pharmacology, Centrum Badań Przedklinicznych, CEPT/Centre For Preclinical Research and Technology (CEPT), Warsaw, Poland. Electronic address: piechal@hotmail.com.
Agnieszka
A
Piechal
Instytut Psychiatrii i Neurologii/Institute of Psychiatry and Neurology, Warsaw, Poland.
Iwona
I
Kurkowska-Jastrzębska
D000328:Adult; D001682:Biological Availability; D003937:Diagnosis, Differential; D004339:Drug Compounding; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects*; D008286:Malabsorption Syndromes / Q000097:blood* / Q000175:diagnosis*; D020190:Myoclonic Epilepsy, Juvenile / Q000097:blood* / Q000188:drug therapy*; D012815:Signal Processing, Computer-Assisted; D016896:Treatment Outcome; D014635:Valproic Acid / Q000493:pharmacokinetics* / Q000627:therapeutic use*
D014635:Valproic Acid
Absorption; Bioavailability; Valproic acid