{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T19:29:35Z","timestamp":1788377375358,"version":"build-2803163510"},"reference-count":21,"publisher":"SAGE Publications","issue":"7-8","license":[{"start":{"date-parts":[[2010,6,29]],"date-time":"2010-06-29T00:00:00Z","timestamp":1277769600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2010,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To review the evidence supporting the efficacy and safety of l-carnitine in the management of acute valproic acid overdose. DATA SOURCES: MEDLINE (1950\u2013May 2010), EMBASE (1980\u2013May 2010), and Google Scholar (to May 2010) were searched, using the terms carnitine, valproic acid, and carnitine for valproic acid overdose. Reference citations from identified publications were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection and Data Extraction:<\/jats:title>\n                    <jats:p>Full-text publications evaluating the use of l-carnitine for management of valproic acid overdose in humans were sought. All studies, regardless of design, case series, and case reports reporting efficacy or safety endpoints were included. All languages were included. Two authors extracted primary data elements including patient demographics, presenting features, clinical management, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis:<\/jats:title>\n                    <jats:p>Seven articles discussing 8 patients and 1 reporting safety data from records of 674 patients were reviewed. Reports covered both pediatric and adult patients with acute exposures to valproic acid mono- and polydrug overdose who were treated with various regimens of l-carnitine. All patients recovered clinically and no adverse effects were noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Published evidence of the efficacy and safety of l-carnitine as an antidote for acute valproic acid overdose is limited. Based on the available evidence, it is reasonable to consider l-carnitine for patients with acute overdose of valproic acid who demonstrate decreased level of consciousness. We recommend intravenous administration of 100 mg\/kg once, followed by infusions of 50 mg\/kg (to a maximum of 3 g per dose) every 8 hours thereafter, continuing until ammonia levels are decreasing (if they were elevated initially) and the patient demonstrates signs of clinical improvement or until adverse events associated with l-carnitine occur.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1p135","type":"journal-article","created":{"date-parts":[[2010,6,29]],"date-time":"2010-06-29T22:47:00Z","timestamp":1277851620000},"page":"1287-1293","source":"Crossref","is-referenced-by-count":89,"title":["L-Carnitine for Acute Valproic Acid Overdose: A Systematic Review of Published Cases"],"prefix":"10.1177","volume":"44","author":[{"given":"Jerrold","family":"Perrott","sequence":"first","affiliation":[{"name":"Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada; now, Clinical Pharmacy Specialist\u2014Critical Care, Royal Columbian Hospital, New Westminster, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy G","family":"Murphy","sequence":"additional","affiliation":[{"name":"IWK Regional Poison Centre; Emergency Physician, Department of Emergency Medicine, Capital Health; Assistant Professor, Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J","family":"Zed","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, and Pharmacotherapeutic Specialist, Emergency Medicine, Queen Elizabeth II Health Sciences Centre; Associate Professor, College of Pharmacy, and Department of Emergency Medicine, Dalhousie University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2010,6,29]]},"reference":[{"key":"bibr1-aph.1P135","doi-asserted-by":"publisher","DOI":"10.34024\/rnc.2008.v16.8650"},{"key":"bibr2-aph.1P135","doi-asserted-by":"publisher","DOI":"10.2165\/00023210-200216100-00004"},{"key":"bibr3-aph.1P135","doi-asserted-by":"publisher","DOI":"10.1081\/CLT-120014645"},{"key":"bibr4-aph.1P135","doi-asserted-by":"publisher","DOI":"10.1186\/cc3742"},{"key":"bibr5-aph.1P135","doi-asserted-by":"publisher","DOI":"10.3109\/15563650903438566"},{"key":"bibr6-aph.1P135","first-page":"755","volume":"38","author":"Spiller HA","year":"2000","journal-title":"Clin Toxicol"},{"key":"bibr7-aph.1P135","unstructured":"Product monograph. Carnitor (levocarnitine). Gaithersburg, MD: Sigma-Tau Pharmaceuticals, 2004. www.carnitor.com\/downloads\/VIFS_6.pdf (accessed 2010 Jan 24)."},{"key":"bibr8-aph.1P135","doi-asserted-by":"crossref","unstructured":"IshikuraH, MatsuoN, MatsubaraM. Levels of evidence. In: Oxford Centre for Evidence Based Medicine (March 2009). Valproic acid overdose and L-carnitine therapy. J Anal Toxicol 1996;20:55-8.","DOI":"10.1093\/jat\/20.1.55"},{"key":"bibr9-aph.1P135","doi-asserted-by":"crossref","unstructured":"MurakamiK, SugimotoT, WooM. Effect of L-carnitine supplementation on acute valproate intoxication. Epilepsia 1996;37:687-9.","DOI":"10.1111\/j.1528-1157.1996.tb00634.x"},{"key":"bibr10-aph.1P135","unstructured":"HoughtonBL, BowersJB. Valproic acid overdose: a case report and review of therapy. MedGenMed 2003;5(1). www.medscape.com\/viewarticle\/445062 (accessed 2010 Jan 24)."},{"key":"bibr11-aph.1P135","doi-asserted-by":"publisher","DOI":"10.1016\/j.annfar.2003.11.018"},{"key":"bibr12-aph.1P135","doi-asserted-by":"publisher","DOI":"10.1177\/0960327107087799"},{"key":"bibr13-aph.1P135","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2007.06.020"},{"key":"bibr14-aph.1P135","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2007.07.032"},{"key":"bibr15-aph.1P135","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2005.02.015"},{"key":"bibr16-aph.1P135","doi-asserted-by":"crossref","unstructured":"BrassEP, AdlerS, SietsemaKE. Intravenous L-carnitine increases carnitine, reduces fatigue, and may preserve exercise capacity in hemodialysis patients. Am J Kidney Dis 2001;37:1018-28. DOI 10.1053\/ajkd.2001.23647","DOI":"10.1016\/S0272-6386(05)80019-8"},{"key":"bibr17-aph.1P135","doi-asserted-by":"crossref","unstructured":"CrucianiRA, DvorkinE, HomelP. Safety, tolerability and symptom outcomes associated with L-carnitine supplementation in patients with cancer, fatigue, and carnitine deficiency: a phase I\/II study. J Pain Symptom Manage 2006;32:551-9. DOI 10.1016\/j.jpainsymman.2006.09.001","DOI":"10.1016\/j.jpainsymman.2006.09.001"},{"key":"bibr18-aph.1P135","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2008.08.008"},{"key":"bibr19-aph.1P135","unstructured":"GoldfrankLR, NelsonLS, HowlandMA, LewinNA, FlomenbaumNE, HoffmanRS, eds. Goldfrank's toxicologic emergencies. 8th ed. New York: McGraw-Hill, 2006."},{"key":"bibr20-aph.1P135","unstructured":"OlsenKR, BenowitzNL, BlancPD, eds. Poisoning and drug overdose. 5th ed. New York: McGraw-Hill, 2006."},{"key":"bibr21-aph.1P135","unstructured":"Centre for evidence based medicine. www.cebm.net\/index.aspx?o=1025 (accessed 2010 Jan 20)."}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1P135","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1P135","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:07:49Z","timestamp":1777374469000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.1P135"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,6,29]]},"references-count":21,"journal-issue":{"issue":"7-8","published-print":{"date-parts":[[2010,7]]}},"alternative-id":["10.1345\/aph.1P135"],"URL":"https:\/\/doi.org\/10.1345\/aph.1p135","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,6,29]]}}}