Valproate-Induced Hyperammonemia in the Psychiatric Setting: 2 Cases

Letter to the Editor

Sir: Although several case reports have described valproate induced
reversible elevation of serum ammonia levels, this
problem may not be recognized quickly owing to lack of sufficient
awareness. A high level of suspicion will enable the busy
clinician to identify and intervene promptly in this clinical setting.
This is particularly relevant in today’s clinical psychiatric
practice owing to the current widespread use of valproate in the
acute and maintenance treatment of psychiatric disorders.