The Relationship between the Level of Consciousness and Other Signs and Symptoms in Patients Poisoned with Oral Valproic Acid

Valproic acid is prescribed in many clinical cases. Decreased level of consciousness is one of the most prominent symptoms of valproic acid poisoning. The aim of this study was to investigate the relationship between the level of consciousness and other symptoms of poisoning and therapeutic outcome in patients poisoned with oral valproic acid.

This study was performed as a cross-sectional study using the information of patients with valproic acid poisoning admitted to Khorshid hospital in Isfahan, Iran, during the years 2018 and 2019. The data about demographic characteristics and patients’ signs and symptoms were collected from hospital records by using a checklist, and were analyzed.

Data of 243 patients poisoned with valproic acid were analyzed. At the time of admission, 194 patients (79.8%) were alert, and respiratory status was normal in 237 cases (97.5%). Sodium levels in 218 patients (92.8%) and potassium levels in 212 cases (91%) were normal. Analysis of venous blood gases showed metabolic acidosis in 45 cases (19.2%). In these patients, respiratory status showed a significant relationship with the level of consciousness (P < 0.001), and the level of consciousness had a significant relationship with therapeutic outcome (aspiration pneumonia) (P < 0.001).

The results of this study showed that most of the patients poisoned with valproic acid had benign disorders, and would have complete recovery with treatment. In cases of acute poisoning and decreased level of deep consciousness, it is important to pay attention to the patients’ respiratory status, and the necessary measures should be taken to prevent aspiration as a therapeutic consequence.