Berker Duman1, Kazım Cihan Can2, Ece Ağtaş-Ertan3, Seyda Erdoğan4, Rıfat Serav İlhan3, Özlem Doğan5, Hakan Kumbasar6, Ulaş Mehmet Çamsarı7. 1. Division of Consultation-Liaison Psychiatry, Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey. Electronic address: dumanb@ankara.edu.tr. 2. Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey. Electronic address: kcan@ankara.edu.tr. 3. Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey. 4. Department of Neurology, Ankara University School of Medicine, Ankara, Turkey. 5. Department of Biochemistry, Ankara University School of Medicine, Ankara, Turkey. Electronic address: ozlemdogan@ankara.edu.tr. 6. Division of Consultation-Liaison Psychiatry, Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey. Electronic address: kumbasar@medicine.ankara.edu.tr. 7. Department of Psychiatry and Psychology, Mayo Clinic School of Medicine and Science, Rochester, MN, USA.
Abstract
OBJECTIVE: Valproic acid (VPA)-induced hyperammonemia (VIH), is an increase in blood ammonia levels without any alteration of hepatic enzymes, which can occur during VPA treatment. We aimed to determine the prevalence rate and the risk factors for VIH and its association with cognitive functions. METHOD: A prospective, cross-sectional study was conducted. Patients aged between 18 and 64 who were on VPA treatment and who diagnosed with mood disorders or epilepsy were enrolled in this study (n = 107). For cognitive assessment, Serial 7's and Subjective Memory Complaints Questionnaire (SMCQ) were used. Blood samples were collected for blood VPA and ammonia levels along with other laboratory tests. RESULTS: 55,3% of the sample were considered as VIH. Blood ammonia level significantly correlates with VPA blood levels, total daily dose of VPA and total number of medications concurrently used, but no significant correlation was found between blood ammonia level and cognitive test scores. Gender, body weight, blood VPA levels and the total number of medications concurrently used significantly predicted blood ammonia levels (F(4,81) = 2670, p = 0,038, R2 = 0,116). CONCLUSION: VIH is relatively high in our sample. There is a dose-dependent association between VPA and blood ammonia level. No association was found between cognitive functions and hyperammonemia however with some limitations. Future, prospective cohort studies are needed.
OBJECTIVE:Valproic acid (VPA)-induced hyperammonemia (VIH), is an increase in blood ammonia levels without any alteration of hepatic enzymes, which can occur during VPA treatment. We aimed to determine the prevalence rate and the risk factors for VIH and its association with cognitive functions. METHOD: A prospective, cross-sectional study was conducted. Patients aged between 18 and 64 who were on VPA treatment and who diagnosed with mood disorders or epilepsy were enrolled in this study (n = 107). For cognitive assessment, Serial 7's and Subjective Memory Complaints Questionnaire (SMCQ) were used. Blood samples were collected for blood VPA and ammonia levels along with other laboratory tests. RESULTS: 55,3% of the sample were considered as VIH. Blood ammonia level significantly correlates with VPA blood levels, total daily dose of VPA and total number of medications concurrently used, but no significant correlation was found between blood ammonia level and cognitive test scores. Gender, body weight, blood VPA levels and the total number of medications concurrently used significantly predicted blood ammonia levels (F(4,81) = 2670, p = 0,038, R2 = 0,116). CONCLUSION:VIH is relatively high in our sample. There is a dose-dependent association between VPA and blood ammonia level. No association was found between cognitive functions and hyperammonemia however with some limitations. Future, prospective cohort studies are needed.
Authors: Jing Li; Maxim Nelis; Jo Sourbron; Daniëlle Copmans; Lieven Lagae; Deirdre Cabooter; Peter A M de Witte Journal: Neurochem Res Date: 2021-05-26 Impact factor: 3.996