Non-Fatal and Fatal Liver Failure Associated with Valproic Acid

作者：Schmid M M^*; Freudenmann R W; Keller F; Connemann B J; Hiemke C; Gahr M; Kratzer W; Fuchs M; Schonfeldt Lecuona C

来源：Pharmacopsychiatry, 2013, 46(2): 63-68.

DOI：10.1055/s-0032-1323671

• valproic acid
• hepatotoxicity
• liver failure
• pharmacovigilance

Introduction: Little is known about hepatotoxicity associated with valproic acid (VPA), a widely used substance in neuropsychiatry. %26lt;br%26gt;Methods: All reported cases to the German Federal Institute for Drugs and Medical Devices between 1993 and 2009 of VPA-induced serious hepatic side effects were evaluated. %26lt;br%26gt;Results: A total of 132 cases of serious VPA-associated liver failure were identified. Approximately one third (34.8 %) occurred under VPA monotherapy, while the majority was seen with VPA plus co-medication, most frequently antiepileptics (34.8 %) and benzodiazepines (16.7 %). A subgroup of 34 cases (25.8 %) had a fatal outcome, the largest number reported to date. Of these, 32.4 % were under VPA monotherapy and 67.6 % under VPA plus concomitant medication. Within the study period a significant increase in the total number of reported cases and the subgroup of fatal cases was found. %26lt;br%26gt;Discussion: This first pharmacovigilance study of VPA-associated liver failure indicates a higher rate of non-fatal and fatal liver failure when VPA is given with co-medication as compared to monotherapy. However, co-medication per se does not increase the risk of fatalities.

• 出版日期2013-3