LIFE-THREATENING INTOXICATION WITH SODIUM VALPROATE

Two female epileptics, 19 and 27 years old, were admitted after ingest ion of an overdose of sodium valproate. The patients were comatose for 6 and 7 days and required mechanical ventilation for 7 and 10 days. B oth patients were in deep coma for several days after serum concentrat ions had dropped into the therapeutic range. Serum concentrations of s odium valproate were 3348 mu mol/L (482 mg/mL) in one patient and more than 10,000 mu mol/L (1440 mg/mL) in the other. Drug elimination foll owed first order kinetics, and the plasma half-lives of sodium valproa te were 19 and 20 hours, respectively. Their anemia, leucopenia and th rombocytopenia required transfusion. Liver enzymes were only moderatel y elevated, but one of the patients developed acute pancreatitis. Ther e were no apparent sequelae two weeks after discharge from the hospita l.