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A case of pancytopenia

Lookup NU author(s): Dr Patrick Keown, Professor Hamish McAllister-Williams, Professor Allan Young

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Abstract

Sodium valproate is a commonly used anticonvulsant, particularly in the management of childhood refractory epilepsy. There is a good literature base regarding its haematological effects in this group of patients including the potential for toxic effect on the bone marrow. Valproate is increasingly being used in the treatment of psychiatric conditions, particularly bipolar affective disorder. In this article we describe a case of pancytopenia associated with a valproate level of 166 mg/l. The population of psychiatric patients is different in several ways from the population of children and young adults with epilepsy from whom the existing data comes. The psychiatric patients are older, more likely to misuse substances, more likely to take overdoses and may metabolize valproate more slowly. For these reasons it would be worthwhile investigating the relationship between valproate levels, macrocytosis, platelet counts and B12 levels in this group of patients. The results of such a study would give us a clearer understanding of what the desirable therapeutic range is for valproate in bipolar affective disorder and what, if any, monitoring should be undertaken. © 2006 British Association for Psychopharmacology.


Publication metadata

Author(s): Keown P, McAllister-Williams H, Young A

Publication type: Article

Publication status: Published

Journal: Journal of Psychopharmacology

Year: 2006

Volume: 20

Issue: 5

Pages: 690-692

ISSN (print): 0269-8811

ISSN (electronic): 1461-7285

Publisher: Sage

URL: http://dx.doi.org/10.1177/0269881106065101

DOI: 10.1177/0269881106065101

PubMed id: 16714327


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