Dear Dr. Josef Finsterer, Thank you for your careful and thorough reading of our article the valuable comments. We agree that valproic acid is harmful in mitochondrial disease we want to add described case currently being prosecuted as medical malpractice.

The use of valproic acid (VPA) (also known as Depakote, Depakene, and others) frequently results in elevated plasma ammonia. In some people, hyperammonemia may be clinically significant, resulting in hyperammonemic encephalopathy, which may be severe. Valproic acid-induced hyperammonemic encephalopathy may occur in people with normal liver function, despite normal doses and serum levels of VPA....

AIM The purpose of the present study is to determine the relationship between the anticonvulsant drug use during pregnancy and the presence of malformations in the newborns. METHODS The frequency of malformations in the neonates of epileptic mothers under anticonvulsant treatment was analyzed in two periods, one from 1988 to 1992, which included 76 epileptic mothers, and another from 1996 to ...

QUESTION Some of my pregnant patients are afraid to take their antiepileptic drugs during pregnancy because of the known risk of malformations and the neurodevelopmental problems associated with valproic acid. Are there similar concerns with carbamazepine? ANSWER Similar to valproic acid, carbamazepine increases the risk of neural tube defects; however, it does not increase the risk of other ...

The chapter summarizes literature on the teratogenic effects of anticonvulsants and presents data from the Swedish Medical Birth Register. Many anticonvulsants have a teratogenic effect which varies between individual drugs with the highest risk associated with the use of valproic acid and probably topiramide. For some much used drugs like carbamazepine and lamotrigine the risk is not much elev...

s: 1. Dinesh Lakhanpal and Gurcharan Kaur (2011). Valproic acid mediates disruption in hypothalamo-hypophyseal gonadal axis by upregulating GAD65 and GAD67. A01493 8 th IBRO World Congress of Neuroscience, International Brain Research Organisation, Florence, Italy. 2. Dinesh Lakhanpal and Gurcharan Kaur (2009). Effect of Chronic Valproic Acid Treatment on neuro-glial plasticity in female rats. ...