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A Strategy for Sensitive, Large Scale Quantitative Metabolomics

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Levocarnitine for valproic-acid-induced hyperammonemic encephalopathy.

Christie M Mock¹, Kristen H Schwetschenau

¹Wishard Health Services, Indianapolis, IN 46202, USA. christina.mock@wishard.edu

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists

|December 20, 2011

Summary

Levocarnitine may effectively treat valproic-acid-induced hyperammonemic encephalopathy (VHE). This review suggests levocarnitine is generally safe and beneficial for VHE, particularly in overdose cases.

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Area of Science:

Neurology
Clinical Pharmacology
Biochemistry

Background:

Valproic-acid-induced hyperammonemic encephalopathy (VHE) presents with altered consciousness, neurological deficits, and seizures.
VHE pathogenesis involves toxic valproic acid metabolites and ammonia accumulation.
Carnitine is crucial for valproic acid metabolism and ammonia clearance; deficiency may contribute to hyperammonemia.

Purpose of the Study:

To review the use of levocarnitine for treating valproic-acid-induced hyperammonemic encephalopathy (VHE).

Main Methods:

A literature search of PubMed was conducted for English-language articles from 1948 to May 2011.
Search terms included levocarnitine, l-carnitine, valproic acid, and hyperammonemia encephalopathy.
Review of retrospective trials and case reports on levocarnitine for VHE.

Main Results:

Levocarnitine has demonstrated general safety and effectiveness in treating VHE.
Evidence is stronger for levocarnitine use in VHE from valproic acid overdose compared to standard dosages.
No adverse events associated with levocarnitine therapy were reported in the reviewed literature.

Conclusions:

Levocarnitine is a potentially effective and safe treatment option for VHE.
Further prospective trials are warranted to confirm the efficacy and safety of levocarnitine in VHE treatment.