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Overdosage with Valproate may result somnolence, heart block, hypotension and circulatory collapse/shock, and deep coma. Fatalities have been reported.
The presence of sodium content in the Valproate formulations may lead to hypernatremia when taken in overdose.
In overdose situations, the fraction of drug not bound to protein is high and hemodialysis or tandem hemodialysis plus hemoperfusion may result in significant removal of drug. The benefit of gastric lavage or emesis will vary with the time since ingestion. General supportive measures should be applied with particular attention to the maintenance of adequate urinary output.
Naloxone has been reported to reverse the CNS depressant effects of Valproate overdosage. Because naloxone could theoretically also reverse the antiepileptic effects of Valproate it should be used with caution in patients with epilepsy.
