Valproic Acid–Induced Hyperammonemia in Neuropsychiatric Disorders: A 2-Year Clinical Survey

Valproic Acid–Induced Hyperammonemia in Neuropsychiatric Disorders: A 2-Year Clinical Survey Publisher Pubmed

Hosseini H¹ ; Shafie M^{1, 2} ; Shakiba A³ ; Ghayyem H⁴ ; Mayeli M^{2, 5} ; Hassani M¹ ; Aghamollaii V^{6, 7, 8}

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1. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
2. NeuroTRACT Association, Studentsâ€™ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
3. Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
4. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5. Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
6. Cognitive Neurology and Neuropsychiatry Division, Tehran University of Medical Sciences, Tehran, Iran
7. Department of Neurology, Roozbeh Psychiatric Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
8. Department of Neurology, Roozbeh Psychiatric Hospital, School of Medicine, Tehran University of Medical Sciences, South Kargar Street, Tehran, 1333715914, Iran

Source: Psychopharmacology Published:2023

Abstract

Introduction: Valproic acid (VPA)–induced hyperammonemia (HA) is a rare adverse effect reported even at therapeutic VPA levels. The present study aimed to investigate the characteristics of VPA-induced HA and its association with the total dose, duration, and level of VPA. This study also investigated whether the use of VPA in combination with other medications has any effect on elevating serum ammonia levels. Methods: A total of 316 patients with a history of VPA prescribed for underlying neuropsychiatric disorders were found eligible for the study. Data including demographic information, medical history and diagnosis, VPA dosage, VPA treatment duration, VPA level, and ammonia serum level were extracted and reviewed from our hospital records. The history of other neuropsychiatric medications was also included. Results: Among 316 patients receiving VPA, HA was observed in 54 (17%) patients, and 15 patients were symptomatic among them. There was no significant difference in demographics between symptomatic and asymptomatic HA groups except for the number of co-administrated medications (p = 0.044). Besides, VPA duration and dose did not show a significant difference between the two groups. Additionally, the VPA level was significantly higher in patients who used risperidone in addition to VPA (p = 0.019). Eventually, VPA level showed a significant association with ammonia level (p = 0.025) and symptomatic HA (p = 0.033) after adjusting for possible confounders. Conclusion: VPA level showed a significant association with ammonia level and symptomatic HA. Moreover, co-administrated medications such as risperidone might have an impact on the serum level of VPA. Further studies are recommended to confirm these findings. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Style	Citing Format
MLA	Hosseini H, et al.. "Valproic Acid–Induced Hyperammonemia in Neuropsychiatric Disorders: A 2-Year Clinical Survey." Psychopharmacology, vol. 240, no. 1, 2023, pp. 149-156.
APA	Hosseini H, Shafie M, Shakiba A, Ghayyem H, Mayeli M, Hassani M, Aghamollaii V (2023). Valproic Acid–Induced Hyperammonemia in Neuropsychiatric Disorders: A 2-Year Clinical Survey. Psychopharmacology, 240(1), 149-156.
Chicago	Hosseini H, Shafie M, Shakiba A, Ghayyem H, Mayeli M, Hassani M, Aghamollaii V. "Valproic Acid–Induced Hyperammonemia in Neuropsychiatric Disorders: A 2-Year Clinical Survey." Psychopharmacology 240, no. 1 (2023): 149-156.
Harvard	Hosseini H et al. (2023) 'Valproic Acid–Induced Hyperammonemia in Neuropsychiatric Disorders: A 2-Year Clinical Survey', Psychopharmacology, 240(1), pp. 149-156.
Vancouver	Hosseini H, Shafie M, Shakiba A, Ghayyem H, Mayeli M, Hassani M, et al.. Valproic Acid–Induced Hyperammonemia in Neuropsychiatric Disorders: A 2-Year Clinical Survey. Psychopharmacology. 2023;240(1):149-156.
BibTex	@article{ author = {Hosseini H and Shafie M and Shakiba A and Ghayyem H and Mayeli M and Hassani M and Aghamollaii V}, title = {Valproic Acid–Induced Hyperammonemia in Neuropsychiatric Disorders: A 2-Year Clinical Survey}, journal = {Psychopharmacology}, volume = {240}, number = {1}, pages = {149-156}, year = {2023} }
RIS	TY - JOUR AU - Hosseini H AU - Shafie M AU - Shakiba A AU - Ghayyem H AU - Mayeli M AU - Hassani M AU - Aghamollaii V TI - Valproic Acid–Induced Hyperammonemia in Neuropsychiatric Disorders: A 2-Year Clinical Survey JO - Psychopharmacology VL - 240 IS - 1 SP - 149 EP - 156 PY - 2023 ER -

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