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Updated: May 19, 2026
09:44
Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
Published on: November 27, 2019
Non-fatal and fatal liver failure associated with valproic acid
M M Schmid1, R W Freudenmann, F Keller
1Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany. markus.schmid@uni-ulm.de
Pharmacopsychiatry
|August 24, 2012
Summary
Valproic acid (VPA) can cause serious liver damage, especially when combined with other medications. This study found an increase in VPA-related liver failure cases, including fatal outcomes, over time.
Area of Science:
- Pharmacovigilance
- Hepatotoxicity
- Neuropsychiatry
Background:
- Valproic acid (VPA) is widely used in neuropsychiatry.
- Hepatotoxicity associated with VPA is not well understood.
- Serious hepatic side effects of VPA require thorough investigation.
Purpose of the Study:
- To evaluate VPA-induced serious hepatic side effects.
- To analyze VPA-associated liver failure cases reported to German regulatory authorities.
- To assess the impact of co-medication on VPA hepatotoxicity.
Main Methods:
- Retrospective analysis of reported cases (1993-2009).
- Inclusion of serious VPA-associated hepatic side effects.
- Evaluation of monotherapy versus co-medication scenarios.
Main Results:
- 132 cases of serious VPA-associated liver failure identified.
- Higher incidence of liver failure with VPA plus co-medication (antiepileptics, benzodiazepines) compared to monotherapy.
- Significant increase in reported non-fatal and fatal cases over the study period, with 34 fatal outcomes.
Conclusions:
- VPA co-medication is associated with increased rates of non-fatal and fatal liver failure.
- Pharmacovigilance data indicates a growing concern for VPA-induced liver injury.
- While co-medication increases risk, it does not independently elevate fatality risk.
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