FAVOURABLE RESULTS FOR L-CARNITINE USE IN VALPROIC
ACID ACUTE POISONING
RADU CIPRIAN ŢINCU1,2#*, CRISTIAN COBILINSCHI3#, DANA TOMESCU4,5#, LAURENŢIU COMAN6#, IULIA ŢINCU7#, CAMELIA DIACONU8#, RADU ALEXANDRU MACOVEI1,2#
1Clinical Emergency Hospital Bucharest, Critical Care Toxicology Unit, 8 Floreasca Way, 014451, Bucharest, Romania
2“Carol Davila” University of Medicine and Pharmacy, Faculty of Medicine, Department of Orthopaedics – Anaesthesiology
and Intensive Care, Discipline of Pharmacology, Toxicology and Clinical Psychopharmacology, 8 Floreasca Way, 014451,
Bucharest, Romania
3 Clinical Emergency Hospital Bucharest, Anaesthesiology Intensive Care Unit, 8 Floreasca Way, 014451, Bucharest, Romania
4 “Fundeni” Clinical Institute, Anaesthesiology Intensive Care Unit, 258 Fundeni Street, 022328, Bucharest, Romania
5“Carol Davila” University of Medicine and Pharmacy, Faculty of Medicine, Department of Orthopaedics – Anaesthesiology
and Intensive Care, Discipline Anaesthesiology and Intensive Care, 258 Fundeni Street, 022328, Bucharest, Romania
6“Carol Davila” University of Medicine and Pharmacy, Faculty of Pharmacy, Physiology Department, 6 Traian Vuia Street,
020956, Bucharest, Romania
7“Grigore Alexandrescu” Emergency Children Hospital, Emergency Department, 30-32 Iancu de Hunedoara Avenue, 11743,
Bucharest, Romania
8“Carol Davila” University of Medicine and Pharmacy, Clinical Emergency Hospital Bucharest, Internal Medicine Unit,
Bucharest, Romania
*corresponding author: r_tincu@yahoo.com
#All authors contributed equally to this work and thus share first authorship.
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Abstract:
Valproic acid (VPA) is a fatty acid with anticonvulsant properties. The aim of our present study was to investigate the effect
of levo-carnitine supplementation on serum NH3 and clinical recovery in patients with VPA intoxication. This study included
all patients admitted for acute VPA poisoning (VPA > 100 μg/mL), in 2014, in our clinic. Blood samples were obtained in
order to analyse NH3, VPA concentrations and biochemical status. The patients were allocated to receive standard therapy
(Group 1) or 1800 mg of L-carnitine/day together with standard therapy (Group 2) for 3 days. A total of 62 patients were
finally enrolled in the study. The median (IQR) ingested dose of VPA was 1000 mg (800 mg, 1200 mg [range; 800 - 6000 mg]).
L-Carnitine supplementation resulted in significant reductions in ammonemia (47.9 ± 6 vs. 61.9 ± 11.39 μmol/L), determined
after 24 hours, levels compared with baseline (p < 0.001). The trend was similar for plasma VPA levels. The use of Lcarnitine
accelerates the elimination of VPA and facilitates the decrease in ammonia plasma levels.






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