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Macrocytosis associated with divalproex treatment

Ruth Tsivkin1, Ema Saito, Vivian Kafantaris

  • 1Division of Child and Adolescent Psychiatry, The Zucker Hillside Hospital, New Hyde Park, New York 11040, USA.

Journal of Child and Adolescent Psychopharmacology
|December 29, 2005
PubMed

Insights

Divalproex (DVP) treatment in children may cause macrocytosis and low platelet counts. Closer monitoring of blood counts is recommended to detect these hematologic adverse effects.

Area of Science:

  • Pediatric Hematology
  • Child and Adolescent Psychiatry
  • Clinical Pharmacology

Background:

  • Divalproex (DVP) is frequently prescribed for pediatric psychiatric conditions.
  • Hematologic adverse effects, particularly thrombocytopenia, are known side effects of DVP.
  • The occurrence of macrocytosis as a DVP adverse effect is less documented.

Observation:

  • Two pediatric cases of DVP treatment are presented.
  • Both patients developed macrocytosis and decreasing platelet counts.
  • The macrocytosis was asymptomatic and nonprogressive in these cases.

Findings:

  • Divalproex (DVP) can induce macrocytosis in pediatric patients.
  • Concurrent thrombocytopenia was observed in conjunction with macrocytosis.
  • These hematologic changes are potential adverse effects of DVP therapy.

Implications:

  • Highlights the need for vigilant monitoring of complete blood counts in pediatric patients on DVP.
  • Suggests surveillance for both anemia and thrombocytopenia.
  • Emphasizes the importance of recognizing less common DVP-associated hematologic abnormalities.

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