The effects of valproic acid on liver function.

To study a possible enzyme-inducing potency of valproic acid (VPA) in children, serum gamma-glutamyltranspeptidase (GGT) activity in serum and D-glucaric acid (GLA) excretion in urine were measured in 32 epileptic children who were on sodium valproate monotherapy (29.6 +/- 10.3 mg/kg/day). VPA did not affect GGT activity, but it selectively enhanced GLA excretion. To approach this phenomenon experimentally an attempt was made to induce a similar effect in animals. In guinea pigs it was possible to provoke a VPA induced rise in GLA excretion. In addition, vacuolisation of the cytoplasm of the hepatic parenchymal cells was observed. The question of the possible relationship between VPA hepatotoxicity and stimulation of GLA excretion remains to be answered.