Department of Pharmacy Practice, J.S.S. College of Pharmacy, Mysore, India.
Indian J Psychiatry. 2010 Jan;52(1):71-3. doi: 10.4103/0019-5545.58900.
A 12-year-old female was admitted to hospital with complaints of abnormal behavior. She was on valproic acid 200mg twice daily and clobazam 5mg at night for the past 13 weeks for her complex partial seizures with secondary generalized seizures. On day 60 of the treatment with valproic acid she developed behavioral disturbances and initiated treatment with tablet chlorpromazine, olanzapine and risperidone. During the present hospitalization, as there was no improvement in abnormal behavior, antipsychotics were discontinued and she was on observation for five days. On day 6, valproic acid was replaced with carbamazepine. Patient started recovering gradually from the abnormal behavior three days after the withdrawal of valproic acid and completely recovered after three months. Causality of valproic acid-induced abnormal behavior was 'possible'. Behavioral disturbances associated with valproic acid are rare and is reversible upon discontinuation of the drug. There is a need for vigilance on abnormal behavioral effects in patients receiving valproic acid.
一位 12 岁女性因异常行为到医院就诊。她在过去 13 周内接受丙戊酸钠 200mg 每日两次和氯硝西泮 5mg 每晚治疗复杂部分性发作继发全面性发作。在使用丙戊酸钠治疗的第 60 天，她出现行为障碍，并开始服用氯丙嗪片、奥氮平片和利培酮。在本次住院期间，由于异常行为没有改善，停用了抗精神病药物，并观察了五天。第 6 天，用卡马西平替换了丙戊酸钠。患者在停用丙戊酸钠三天后逐渐从异常行为中恢复，三个月后完全恢复。丙戊酸钠引起的异常行为的因果关系为“可能”。与丙戊酸钠相关的行为障碍很少见，停药后可逆转。在使用丙戊酸钠的患者中，需要警惕异常行为的影响。
