BLOOD LABORATORY TESTS AND CLINICAL MONITORING RECOMMENDED FOR EARLY DETECTION OF VALPROATE ASSOCIATED LIVER-FAILURE

Valproate is a frequently used antiepileptic drug. It is associated wi th rare but serious adverse effects like liver failure. The first symp tom is impairment of the patient's well being. Isolated changes of sta ndard laboratory liver parameters are not reliable early indicators,Th us, according to the knowledge of today, prophylactic blood screening cannot predict complications. On the contrary, clinical symptoms are t he most relevant indicators of impending complications, eventually sup ported by laboratory findings. An abrupt withdrawl of valproate and ad ministering carnitin in parallel can interrupt the otherwise fatal cou rse of the complication and induce a subsequent recovery. At a Consens us Conference the current knowledge about early detection and therapy of the valproate-induced serious hepatotoxicity was discussed. The res ults regarding recommended laboratory screening, as well as diagnostic and therapeutic strategies are reported.