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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Main Authors: James Kwok, Janeline Wong, Kye Kim
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Case Reports in Psychiatry
Online Access:http://dx.doi.org/10.1155/2024/1426930
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author James Kwok
Janeline Wong
Kye Kim
author_facet James Kwok
Janeline Wong
Kye Kim
author_sort James Kwok
collection DOAJ
description 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.
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series Case Reports in Psychiatry
spelling doaj-art-8e461cc22e044477a724865c74cfb7a22025-08-20T03:37:17ZengWileyCase Reports in Psychiatry2090-68382024-01-01202410.1155/2024/1426930Management Challenges and Potential Malabsorption of Valproic Acid in a Patient with Bipolar Disorder and Gastrointestinal HistoryJames Kwok0Janeline Wong1Kye Kim2Virginia Tech Carilion School of MedicineVirginia Tech Carilion School of MedicineVirginia Tech Carilion School of MedicineBipolar 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.http://dx.doi.org/10.1155/2024/1426930
spellingShingle James Kwok
Janeline Wong
Kye Kim
Management Challenges and Potential Malabsorption of Valproic Acid in a Patient with Bipolar Disorder and Gastrointestinal History
Case Reports in Psychiatry
title Management Challenges and Potential Malabsorption of Valproic Acid in a Patient with Bipolar Disorder and Gastrointestinal History
title_full Management Challenges and Potential Malabsorption of Valproic Acid in a Patient with Bipolar Disorder and Gastrointestinal History
title_fullStr Management Challenges and Potential Malabsorption of Valproic Acid in a Patient with Bipolar Disorder and Gastrointestinal History
title_full_unstemmed Management Challenges and Potential Malabsorption of Valproic Acid in a Patient with Bipolar Disorder and Gastrointestinal History
title_short Management Challenges and Potential Malabsorption of Valproic Acid in a Patient with Bipolar Disorder and Gastrointestinal History
title_sort management challenges and potential malabsorption of valproic acid in a patient with bipolar disorder and gastrointestinal history
url http://dx.doi.org/10.1155/2024/1426930
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