Valproate overdose: a comparative cohort study of self poisonings.

摘要: Aims  Based on individual case reports of massive overdoses, valproate is often regarded as having significant toxicity. This study aimed to describe the epidemiology poisoning and spectrum its clinical effects. Methods  Consecutive poisonings were identified compared with other anticonvulsant overdoses all poisonings, from a prospective database admissions presenting regional toxicology service. National prescription data for same period obtained. Results  There 79 patients January 1991 November 2001, 15 cases alone. Of cases, drowsiness occurred in two (both taking> 200 mg kg−1), vomiting four tachycardia five. In co-ingesting medications, moderate severe effects consistent co-ingestants. was one death not directly related valproate. One patient had metabolic acidosis thrombocytopaenia Comparison valproate, carbamazepine, phenytoin control groups showed that length stay both carbamazepine significantly longer than (P < 0.0001), there increased risk intensive care unit admission vs (OR 2.73; 95% CI 1.22, 6.28; P = 0.015). Although prescriptions over 10 years, relatively greater increase incidence poisoning. The odds overdose 1992 0.29 (95% 0.07, 1.28; P = 0.141), but 2001 2.73 1.38, 5.39; P = 0.004). Conclusions  Valproate causes mild toxicity majority cases. Massive 400 mg kg−1 can cause toxicity, these are uncommon. older anticonvulsants remain problem overdose.