Hyperammonemic Encephalopathy Without Hepatic Dysfunction Due to Treatment With Valproate: Four Cases and a Mini Review

    March 2018 in “ Psychiatry and Clinical Psychopharmacology ”
    Mustafa Dinçer, Abdullah Akgün, Şahin Bodur, Hesna Gül, Yasemin Taş Torun, Abdullah Bolu, Cemil Çelík, Miray Çetinkaya, Halil Kara, Mehmet Ayhan Cöngöloğlu
    TLDR Valproate can cause brain swelling with high ammonia levels, possibly underreported, especially in psychiatric patients.
    The document discussed four cases of hyperammonemic encephalopathy (HE) induced by valproate (VPA) treatment in patients without hepatic dysfunction, highlighting a significant side effect of this commonly prescribed antiepileptic drug. Valproate-induced hyperammonemia occurred in nearly 50% of patients, with some developing encephalopathy. The study emphasized that while this side effect is well-documented in neurological patients, it is less recognized in psychiatric patients, despite potentially occurring more frequently and earlier in this group. The authors presented five cases from their clinic and reviewed other reports, suggesting that VHE might often be overlooked in psychiatric settings.
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