Sir,I read with interest, the recent case presentation by Nasa et al. regarding the effectiveness of hemodialysis in a case of severe valproateoverdose published in your journal.[1]The authors stated that naloxone acted as a GABA antagonist. However, their patient did not show any improvement with naloxone. As you know, according to the textbook of Goldfrank's Toxicologic Emergencies, naloxone is not effective in valproic acid-induced central nervous system (CNS) or respiratory depression.[2] In contrast, although the clinical experience with naloxone in reversing valproic acid-related CNS or respiratory depression is too limited to allow for in depth analysis, one review of the literature has suggested that standard-dose naloxone has utility in mild to moderate cases of CNS depression and massive valproic acidoverdoses may require larger naloxone doses, or, alternatively, naloxone may simply be ineffective in such a situation.[3]