Sodium Valproate-Induced Bicytopenia: A Case Report

Sodium valproate is widely prescribed for epilepsy and mood disorders but is associated with significant adverse effects, including haematological abnormalities. We report a young male patient who developed bicytopenia following an increase in valproate dose after admission with status epilepticus. Despite gradual dose reduction, both haemoglobin and platelet levels worsened, ultimately requiring transfusion. Further history revealed poor adherence at home, which means that hospital-administered dosing inadvertently led to relative overexposure. A reduced maintenance dose stabilised serum valproate levels, returned blood counts towards baseline, and maintained adequate seizure control. This case illustrates the importance of considering both drug toxicity and medication adherence when evaluating treatment complications. Vigilant monitoring after dose adjustments, early multidisciplinary involvement, and accurate medication histories are critical to improving outcomes in patients receiving sodium valproate.