SERUM CARNITINE, BETA-HYDROXYBUTYRATE AND AMMONIA LEVELS DURING VALPROIC ACID THERAPY

This study was performed in order to determine the effects of valproic acid on serum free carnitine, beta-hydroxybutyrate and blood amamonia . Serum free carnitine, beta-hydroxyhutyrate and blood ammonia levels were measured in 24 epileptic children and in 24 age and sex-matched c ontrols. The mean serum free carnitine level was significantly lower i n patients taking valproic acid (33.5 +/- 13.1 nmol/ml) than in contro l subjects (50.8 +/- 14.6 nmol/ml) (p < 0.001). The mean blood ammonia level was significantly higher in patients receiving valproic acid (9 3.9 +/- 20.5 mu g/dl) than in controls (79.6 +/- 21.4 mu g/dl) (p < 0. 002). The mean serum beta-hydroxybutyrate level was significantly lowe r in patients taking valproic acid (2.26 +/- 2.24 mg/dl) than in contr ols (4.38 +/- 2.43 mg/dl) (p < 0.001). Our results support the decisio n that valproic acid induces hypo-carnitinemia, hypoketonemia and an I ncreased blood ammonia level.