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shrey

Sodium Valproate

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One my inpatients a 29 year old gentleman was started oon semisodium valproate as mood stabliser week ago and LFT were done at the begining and these were within normal range. Today the ALT was 180 ( N 30-40). He is not showing any physical illness signs. I dont know the guidelines about when to stop the valproate. Anyway I stopped the valproate and ordered for platelet count, PT, LFT again.

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Hi Shrey

What was the starting dose and how soon was it increased?

What was the dose when u stopped it?

Please keep us posted about the repeat bloods

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You did the right thing... the classic paper by Gerner and Stanton and the American textbook of Psychiatry... says you have to discontinue for values that are [highlight]3 times or more[/highlight] the baseline... especially if it is in the immediate periods of starting...

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i was waiting for ur response dorian.did not disappoint. :)

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wont it be better to monitor the LFTs at regular intervals. I am not sure how unwell the patient is to require treatment with mood stabilizer. I have seen patients who have mild rise in ALT/APT but no other LFTs within normal limits. They are able to continue this for long term without any further deterioration.

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