Surineni Kamalakar, Wells Emilee, Schrader Nolan, Costa Gilmar, Ziegler Maggie
Psychiatry, University of Kansas Medical Center, Wichita, USA.
Psychiatry and Behavioral Sciences, University of Kansas School of Medicine-Wichita, Wichita, USA.
Cureus. 2024 Jul 29;16(7):e65670. doi: 10.7759/cureus.65670. eCollection 2024 Jul.
Despite its effectiveness in treating a variety of neurologic and psychiatric conditions, valproate carries many clinically significant adverse effects that are sometimes life-threatening. Due to the potentially severe nature of these adverse effects, providers must communicate these risks to patients and maintain close follow-up, especially during the first six months following drug initiation or dose increase. We present a case of a 64-year-old male with schizoaffective disorder who developed thrombocytopenia following the initiation of valproate. The patient was started on valproate for underlying mental illness, sleep disturbance, and impulsivity, with subsequent development of thrombocytopenia, which required discontinuation of valproate. Platelet levels returned to baseline within two weeks after discontinuation of valproate. This case underscores the potential risk of developing thrombocytopenia with valproate use and highlights the importance of vigilant monitoring and consideration of underlying risk factors before the initiation of therapy.
尽管丙戊酸盐在治疗多种神经和精神疾病方面有效,但它具有许多临床上显著的不良反应,有时甚至危及生命。由于这些不良反应的潜在严重性,医护人员必须将这些风险告知患者并进行密切随访,尤其是在开始用药或增加剂量后的头六个月。我们报告一例64岁患有分裂情感性障碍的男性患者,在开始使用丙戊酸盐后出现血小板减少症。该患者因潜在的精神疾病、睡眠障碍和冲动行为开始使用丙戊酸盐,随后出现血小板减少症,这需要停用丙戊酸盐。停用丙戊酸盐两周内血小板水平恢复到基线。该病例强调了使用丙戊酸盐时发生血小板减少症的潜在风险,并突出了在开始治疗前进行警惕监测和考虑潜在风险因素的重要性。