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.