• Jigar Patel, Ivan Berezowski, Maryann Mazer-Amirshahi, Sarah E Frasure, Quincy K Tran, and Ali Pourmand.
• Department of Emergency Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
• J Emerg Med. 2022 Nov 1; 63 (5): 651655651-655.

BackgroundValproic acid (VPA) is a common antiepileptic drug that is also used routinely for various psychiatric disorders. VPA toxicity typically manifests as central nervous system depression, while hyperammonemic encephalopathy and hepatotoxicity are potentially life-threatening complications.Case ReportWe describe the case of a 56-year-old man who presented to the emergency department after an intentional VPA overdose, was found to have hyperammonemia, and was treated with L-carnitine exclusively. He was subsequently admitted to the hospital for monitoring and serial laboratory testing. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although VPA toxicity has conventionally been managed by gastric decontamination, L-carnitine, and, in severe and refractory cases, extracorporeal removal, recent literature supports the use of carbapenem antibiotics, particularly meropenem. Thus, we report the details of current treatment modalities for VPA toxicity by reviewing current literature.Copyright © 2022 Elsevier Inc. All rights reserved.

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