Hypothyroidism may exacerbate valproate-related hyperammonemic delirium

Lewis C, Deshpande A, Tesar GE, Dale R. Valproate-induced hyperammonemic encephalopathy: a brief review. Curr Med Res Opin 2012; 28: 1039. Krysiak R, Stojko R. Transient hypothyroidism induced by anticonvulsant agents. Neuro Endocrinol Lett 2014; 35: 183. Benedetti MS, Whomsley R, Baltes E, Tonner F. Alteration of thyroid hormone homeostasis by antiepileptic drugs in humans: involvement of glucuronosyltransferase induction. Eur J Clin Pharmacol 2005; 61: 863. Isojarvi JI, Turkka J, Pakarinen AJ, Kotila M, Rattya J, Myllyla VV. Thyroid function in men taking carbamazepine, oxcarbazepine, or valproate for epilepsy. Epilepsia 2001; 42: 930. Rimar D, Kruzel-Davila E, Dori G, Baron E, Bitterman H. Hyperammonemic coma–barking up the wrong tree. J Gen Intern Med 2007; 22: 549. Hitoshi S, Terao Y, Sakuta M. Portal-systemic encephalopathy and hypothalamic hypothyroidism: effect of thyroid hormone on ammonia metabolism. Intern Med 1993; 32: 655. Tajiri J, Shimada T, Naomi S, Umeda T, Sato T. Hepatic dysfunction in primary hypothyroidism. Endocrinol Jpn 1984; 31: 83.