Management Challenges and Potential Malabsorption of Valproic Acid in a Patient with Bipolar Disorder and Gastrointestinal History

Bipolar disorder is a chronic psychiatric condition typically managed using mood stabilizers such as valproic acid, lithium, and atypical antipsychotics, the former which is absorbed in the gastrointestinal tract. This case report presents the challenges encountered in managing bipolar disorder in a...

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Bibliographic Details
Published in:Case reports in psychiatry 2024, Vol.2024 (1), p.1426930
Main Authors: Kwok, James, Wong, Janeline, Kim, Kye
Format: Article
Language:English
Subjects:
Antidepressants
Bioavailability
Bipolar disorder
Case Report
Case reports
Convulsions & seizures
Dementia
Divalproex
Drug dosages
Dysphagia
Epilepsy
Gastrointestinal system
Impulsivity
Patient compliance
Patients
Valproic acid
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Summary:Bipolar disorder is a chronic psychiatric condition typically managed using mood stabilizers such as valproic acid, lithium, and atypical antipsychotics, the former which is absorbed in the gastrointestinal tract. This case report presents the challenges encountered in managing bipolar disorder in a patient with a history of extensive gastrointestinal (GI) issues. The patient was initially treated with lithium but experienced adverse effects, prompting a switch to valproic acid (VPA) tablets. However, due to ongoing GI problems unrelated to her medication and to help improve tolerability, the patient underwent multiple medication formulation changes, including Depakote delayed release tablets, Depakene liquid, and Depakote sprinkle capsules. However, the patient's VPA levels decreased below therapeutic levels after the formulation changes despite medication compliance. This case highlights the importance of considering GI issues in optimization of a treatment plan for patients with bipolar disorder.
ISSN:2090-682X
2090-6838
DOI:10.1155/2024/1426930