A case of severe sodium valproate overdose is presented in which medicinal management failed to reverse coma of the patient. High-flux hemodialysis was then used to eliminate sodium valproate. This case demonstrated the effectiveness of hemodialysis in not only decreasing valproate levels very rapidly but also as an effective anti-coma management.
Meek MF, Broekroelofs J, Yska JP, Egbers PH, Boerma EC, van der Voort PH. Valproic acid intoxication: Sense and non-sense of hemodialysis. Neth J Med 2004;62:333-6.
Field J, Daly FS. Continuous veno-venous hemodiafiltration in sodium valproate overdose complicated by cerebral edema: a case report. Crit Care Resusc 2002;4:173-6..
Spiller HA, Krenzelok EP, Klein-Schwartz W, Winter ML, Weber JA, Sollee DR, et al. Multicenter case series of valproic acid ingestion: Serum concentrations and toxicity. J Toxicol Clin Toxicol 2000;38:755-60.
Kane SL, Constantiner M, Staubus AE, Meinecke CD, Sedor JR. High-flux hemodialysis without hemoperfusion is effective in acute valproic acid overdose. Ann Pharmacother 2000;34:1146-51.
Kay TD, Playford HR, Johnson DW. Hemodialysis versus continuous veno-venous hemodiafiltration in the management of severe valproate overdose. Clin Nephrol 2003;59:56-8.
Dumoulin A, Lapostolle F, Adnet F, Muzynski J, Baud FJ. Acidosis and hyperlactatemia in acute sodium valproate poisoning. Presse Med 1997;26:555-7.
Thanacoody HK. Chronic valproic acid intoxication: reversal by naloxone. Emerg Med J 2007;24:677-8.
LoVecchio F, Shriki J, Samaddar R. L-carnitine was safely administered in the setting of valproate toxicity. Am J Emerg Med 2005;23:321-2.
Israni RK, Kasbekar N, Haynes K, Berns JS. Use of antiepileptic drugs in patients with kidney disease. Semin Dial 2006;19:408-16.
Gubensek J, Buturovic-Ponikvar J, Ponikvar R, Cebular B. Hemodiafiltration and high-flux hemodialysis significantly reduce serum valproate levels inducing epileptic seizures: Case report. Blood Purif 2008;26:379-80.