Effect of Selenium on Valproate-Induced Hyperammonemia
Abstract number :
3.116
Submission category :
Year :
2001
Submission ID :
2972
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
S. Humphreys, PharmD, Social and health Services, Fircrest RHC, Seattle, WA; M.D. Holmes, MD, Neurology, University of Washington, Seattle, WA; G. Murti, MD, Social and Health Services, Fircrest RHC, Seattle, WA
RATIONALE: Experimental evidence suggests that the trace element selenium (Se) may play an important role in the metabolism of valproic acid (VPA). In particular, Se may ameliorate some of the adverse metabolic consequences of VPA by reducing available free radicals. To further evaluate the potential role of Se, we studied the effects of supplemental Se in patients with VPA-induced hyperammonenia.
METHODS: 7 adult patients ranging in age from 25-52 years were studied. All subjects had medically refractory epilepsy, moderate to severe developmental delay, and all were on VPA. All patients had significant elevations of ammonium (NH3), with no explanation found for hyperammonemia aside from the effects of VPA. Every person was administered supplemental Se while being maintained on VPA. We measured Se and NH3 levels before and after supplemental Se was given.
RESULTS: Before supplemental Se, serum Se levels ranged from 97-154 mcg/L (mean 124 mcg/L) and NH3 levels ranged from 57-115 umol/L (mean 98.2 umol/L). After supplemntal Se, serum levels of Se increased an average of 18% (124-161 mcg/L, mean 146 mcg/L) and NH3 levels fell an average of 43% (37-63 umol/L, mean 57.2 umol/L).
CONCLUSIONS: Selenium has the potential to reduce HN3 levels to normal or near ranges in patients with valproate-induced hyperammonemia.