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Valproate-Induced Hyperammonemia as a Cause of Altered Mental Status

Received November 13, 2001; revised April 2, 2002; accepted April 16, 2002. From the VA Greater Los Angeles Healthcare System, Division of Geriatric Psychiatry, Building 500, 3rd Floor South, Los Angeles, CA 90073. Address correspondence to Dr. Feil, UCLA Neuropsychiatric Institute, 760 Westwood Plaza, Room C8-852, Los Angeles, CA 90024-1759. e-mail: DFeil{at}mednet.ucla.edu

The authors describe valproate-induced hyperammonemia and mental status changes in an 88-year-old man, the first known reported case in an elderly patient. They discuss this underrecognized complication of valproate use and the implications for treating elderly patients, in whom valproate use is increasing.

Key Words: Anticonvulsants • Valproate • Side Effects

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