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Effects of long-term valproic acid treatment on hematological and biochemical parameters in adolescent psychiatric inpatients

a retrospective naturalistic study

Amitai, Mayaa,b,d; Sachs, Ephid; Zivony, Amird; Remez, Roeia; Ben Baruch, Reutb; Amit, Ben H.a,d; Kronenberg, Sefia,d; Apter, Alanb,d; Shoval, Gala,d; Weizman, Abrahama,c,d; Zalsman, Gila,c,d,e

International Clinical Psychopharmacology: September 2015 - Volume 30 - Issue 5 - p 241–248
doi: 10.1097/YIC.0000000000000084

The objective of this study was to determine the long-term hematological and biochemical side effects of valproic acid (VPA) in psychiatric adolescent inpatients. A retrospective naturalistic study design was used. Participants were psychiatric inpatients treated with VPA, alone or in combination with other medications. Electronic medical files were reviewed for changes in hematological and biochemical parameters following a course of VPA treatment. One hundred and four adolescents aged 12–18 (mean 15.76±1.58) years fulfilled the study criteria. The mean blood level and duration of VPA treatment were 65.81±22.18 mcg/ml and 98.57±135.94 days, respectively. The mean levels of thyroid-stimulating hormones and triglyceride levels increased significantly from the first to the last measurement. Platelet count decreased significantly following VPA treatment. No correlation was observed between these parameters and age, duration of treatment, or VPA levels. No serious adverse events were reported. Long-term VPA treatment in adolescents with psychiatric disorders is associated with significant increases in triglyceride levels. Moreover, VPA-treated adolescent psychiatric inpatients may be at risk of developing pituitary–thyroid axis dysregulation and decreased platelet count. Therefore, baseline measurement of thyroid functions and metabolic and hematological parameters and monitoring throughout the treatment are recommended.

aDivision of Child and Adolescent Psychiatry, Geha Mental Health Center

bDepartment of Psychological Medicine, Schneider Children’s Medical Center of Israel

cFelsenstein Medical Research Center, Petah Tikva

dDepartment of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

eDepartment of Psychiatry, Divisions of Molecular Imaging and Neuropathology, Columbia University, New York, New York, USA

Correspondence to Maya Amitai, MD, Department of Psychological Medicine, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, PO Box 559, Petah Tikva 49202, Israel Tel: +972 3 9210784; fax: +972 3 9241041; e-mail:

Received February 15, 2015

Accepted April 29, 2015

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