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Yıl:2018; Cilt: 21; Sayı: 1>> Özet
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Klinik Psikiyatri Dergisi; 2018;21(1):102-106
Valproik Asit Kullanımına Bağlı Gelişen Hiperamonyemik Ensefalopati: Olgu Sunumu
F Apa, FÇ Ateşci, GS Varma
Pamukkale Üniversitesi, Denizli
Valproik asit (VPA), çeşitli psikiyatrik ve nörolojik durumlarda yaygın olarak kullanılan antikonvülzan ve duygudurum düzenleyicisidir. Geniş terapötik penceresiyle güvenli bir ilaç olduğu düşünülmektedir. Nadiren valproat kullanımına bağlı hiperamonyemi gelişebilmekte ve VPA ile indüklenen ve karaciğer dışı nedenlerden kaynaklanan hiperamonyemi deliryum oluşturabilmektedir. Bu durumun zamanında fark edilmemesi ensefalopati ve hatta ölümle sonuçlanabilmektedir. Amonyak seviyesinin ölçülmesi, ölümcül olabilecek ama geri döndürülebilir bir durumu ortaya koyması bakımından önemlidir. Bu olgu sunumunda, geçmişte bipolar bozukluk dışında tıbbi bir hastalığı olmayan, VPA ve antipsikotik kullanımı sırasında hiperamonyemi gelişen bir olgunun sunulması ve psikotrop ilaç kullanımı ile ilişkili hiperamonyeminin gözden geçirilmesi amaçlanmıştır.
Valproic acid induced hyperammonemic encephalopathy: A case report
Valproic acid (VPA) is commonly used drug to treat variety of anticonvulsant and mood stabilizer in psychiatric and neurologic cases. It is thought to be a safe drug with a large therapeutic aspect..Uncommonly, hyperammonemia can be progressed by the usage of valproate and VPA induced hyperammonemia delirium-like condition by extrahepatic origin can be constituted. Being unrecognized of this situation in a timely manner can result in encephalopathy and even death. The measurement of the level of ammonia is important to establish a potentially lethal but reversible situation. In this case study, it is aimed that to present hyperammonemia related to the use of psychotropic drugs and to present a patient with hyperammonemia during VPA and antipsychotic use without a medical disease except bipolar disorder in the past.

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