Elgudin Larissa, Hall Yvonne, Schubert Daniel
The University Hospitals of Cleveland, Ohio, USA.
Int J Psychiatry Med. 2003;33(1):91-6. doi: 10.2190/XW8E-Q283-4429-QL71.
Valproic acid is widely used as a mood stabilizer. We report a case of an adult with bipolar disorder taking therapeutic doses of valproic acid, who presented to the emergency department with coma related to hyperammonemia as a complication of valproic acid treatment. Valproic acid was discontinued which resulted in rapid clinical recovery. Valproic acid induced coma was likely related to a urea cycle enzymopathy. Clinicians should consider hyperammonemia in all patients who present with coma and other mental status changes while on valproic acid. In such patients, ammonia level should be obtained in addition to liver function tests.
丙戊酸被广泛用作情绪稳定剂。我们报告一例患有双相情感障碍的成年人，其服用治疗剂量的丙戊酸，因丙戊酸治疗并发症高氨血症导致昏迷而被送往急诊科。停用丙戊酸后患者迅速临床康复。丙戊酸诱导的昏迷可能与尿素循环酶病有关。临床医生应考虑到所有服用丙戊酸时出现昏迷及其他精神状态改变的患者存在高氨血症的可能性。对于此类患者，除肝功能检查外，还应检测血氨水平。
