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What Level Of Serum Ammonia Will Lead To Discontinuation Of Depakote?
Question: In an asymptomatic patient, what elevated serum ammonia level would warrant discontinuation of depakote?
Brief Answer:
Yeah it should be avoided
Detailed Answer:
Hi, thanks for writing through HCM.
It s difficult to tell but if a person who is taking depakote for long time and incidentally he was found to have high levels of ammonia, then it may be because of it, in the absence of other organic reasons. If other reasons can not be found then by exclusion we can say that person has depakote induced hyperammonia.
It can be possible that when ammonia level has started rising but initially it can not cause symptoms up to some level or consider a threshold for development of clinical manifestation of hyperammonia but when this threshold has been reached, person starts developing clinical symptoms.
Normal ammonia level in serum is 15-110 mcg/dl. Case reports has shown that most of the symptomatic presentation occur after 150 mcg/dl. In addition one should also go for serum valproic acid level, so that we can confirm the toxicity of depakote. If someone has higher level of ammonia then he is at high risk of developing encephalopathy if he is receiving depakote.
In my opinion, one should avoid depakote in a asymptomatic hyperammonemic person.
Hope I have answered your query. If you have further query then I shall be happy to help.
Wish you good health.
Yeah it should be avoided
Detailed Answer:
Hi, thanks for writing through HCM.
It s difficult to tell but if a person who is taking depakote for long time and incidentally he was found to have high levels of ammonia, then it may be because of it, in the absence of other organic reasons. If other reasons can not be found then by exclusion we can say that person has depakote induced hyperammonia.
It can be possible that when ammonia level has started rising but initially it can not cause symptoms up to some level or consider a threshold for development of clinical manifestation of hyperammonia but when this threshold has been reached, person starts developing clinical symptoms.
Normal ammonia level in serum is 15-110 mcg/dl. Case reports has shown that most of the symptomatic presentation occur after 150 mcg/dl. In addition one should also go for serum valproic acid level, so that we can confirm the toxicity of depakote. If someone has higher level of ammonia then he is at high risk of developing encephalopathy if he is receiving depakote.
In my opinion, one should avoid depakote in a asymptomatic hyperammonemic person.
Hope I have answered your query. If you have further query then I shall be happy to help.
Wish you good health.
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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