Valproate Induced Delirium due to Hyperammonemia in a Case of Acute Mania: A Diagnostic Dilemma
Divalproex sodium is commonly used drug to treat variety of psychiatric and neurological disorders. Hyperammonemia is infrequent adverse affect of treatment with divalproex sodium. It needs high degree of clinical suspicion or else can lead to delirium of non hepatic origin in some group of patien...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2015-04-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/5758/11830_CE(RA1)_F(T)_PF1(NJAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Divalproex sodium is commonly used drug to treat variety of psychiatric and neurological disorders. Hyperammonemia is infrequent
adverse affect of treatment with divalproex sodium. It needs high degree of clinical suspicion or else can lead to delirium of non
hepatic origin in some group of patients and to medication errors or even death. We hereby report a case of mania who developed
hyperammonemia with normal sodium valproate levels and liver function tests where delirium lead to diagnostic and medication errors.
Withdrawal of divalproex sodium led to clinical recovery but delirium prolonged his hospital stay. This case report cautions the clinicians
about hyperammonemia as the uncommon side effects and emphasizes the need of doing blood ammonia testing in patients treated
with divalproex sodium where recovery is halted or clinical condition worsens despite normal liver function test and EEG. |
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| ISSN: | 2249-782X 0973-709X |