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  • Title: Hyperammonemia induced by interaction of valproate and quetiapine.
    Author: Halaby A, Haddad R, Naja WJ.
    Journal: Curr Drug Saf; 2013 Sep; 8(4):284-6. PubMed ID: 23962184.
    Abstract:
    INTRODUCTION: Hyperammonemia is one of the rare nevertheless serious side effects associated with valproic acid treatment. Two cases of valproic acid induced hyperammonemia are detailed in this article. CASES: Case one describes an adult male who developed hyperammonemia after acute exposure to valproic acid as a treatment for his bipolar disorder-manic episode. Case two developed a similar pattern of toxicity but after chronic exposure to valproic acid. Both patients were receiving a combination of valproic acid and quetiapine. DISCUSSION: Measurement of the ammonium level should be considered where there is a decreased level of consciousness in patients receiving valproic acid irrespective of the diagnosis and even after a long term exposure. A possible risk of hyperammonemia can result from a combination of valproic acid and quetiapine, however further studies are yet needed to confirm this hypothesis.
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