Rationale: Valproic acid can result in a deficiency of carinitine that may contribute to the toxic effects of the valproic acid.
Cons: While there are many reports by people using L-carnitine there have been no controlled studies.
Indications for L-carnitine therapy:
(1) decreased level of consciousness
(2) hyperammonemia
(3) severe liver dysfunction
(4) serum valproic acid concentration > 450 mg/L.
Dosage regimen used by Perrott et al:
(1) initial dose 100 mg per kg body weight IV
(2) infusion every 8 hours of MIN(3 grams, 50 mg per kg)
(3) discontinue whichever of the following occur first:
(3a) ammonia levels falling from hyperammonia or
(3b) clinical improvement or
(3c) severe adverse effects related to the L-carnitine
