Valproate, carnitine metabolism, and biochemical indicators of liver function

E. Beghi, A. Bizzi, A. M. Codegoni, D. Trevisan, W. Torri

Research output: Contribution to journalArticlepeer-review


The effects of valproate (VPA) on carnitine and lipid metabolism and on liver function were assessed in 213 age- and sex-matched outpatients from five centers, with the following distribution: VPA monotherapy, 54; VPA polytherapy, 55; other monotherapies, 51; and untreated, 53. Mean total and free carnitine levels were significantly lower in patients with polytherapy; acylcarnitine was significantly higher for VPA monotherapy and the ratio of acyl- to free carnitine was significantly higher in all patients receiving VPA. Ammonia, uric acid, and bilirubin were the only tests selectively impaired with VPA. A significant correlation was found between serum ammonia and VPA dosage. Glucose, β-lipoproteins, tryglicerides, acetacetate, and β-hydroxybutyrate were unchanged in the four groups. Sex and age appeared to interact with total and free carnitine values. Adverse drug reactions were apparently unrelated to carnitine metabolism impairment. Only a few patients had abnormal carnitine values. Our data support the assumption that carnitine deficiency and abnormal liver function due to VPA are mostly subclinical events.

Original languageEnglish
Pages (from-to)346-352
Number of pages7
Issue number3
Publication statusPublished - 1990


  • Adverse effects
  • Anticonvulsants
  • Carnitine
  • Drug-induced abnormalities
  • Valproate

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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