Effect of L‐Carnitine Supplementation on Acute Valproate Intoxication

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Abstract
Summary: We analyzed urinary valproate (VPA) metabolites and carnitine concentrations in a child who accidentally ingested 400 mg/kg VPA. The concentration of 4‐en VPA, the presumed major factor in VPA‐induced hepato‐toxicity, was markedly increased, without liver dysfunction or hyperammonemia. The other major abnormality was decreased β‐oxidation and markedly increased ω‐oxidation. After L‐carnitine supplementation, VPA metabolism returned to normal. The level of valproylcarnitine was not increased and therefore was not affected by L‐carnitine. L‐Carnitine may be useful in treating patients with coma after VPA overdose.