Clozapine+Depakote Flashcards
(16 cards)
What is Hyperammonemia?
Too much ammonia in the blood.
Ammonia is toxic to the brain, causing confusion, lethargy, tremors, seizures, and even coma.
What are the symptoms of Hyperammonemia?
Confusion, lethargy, tremors, seizures, coma.
Think of ammonia like brain fog that turns into a thunderstorm if it builds up.
What is Depakote also known as?
Valproate.
Depakote is a mood stabilizer used for bipolar disorder, aggression, mood swings, and seizures.
How does Depakote affect ammonia levels?
Increases ammonia levels by messing with liver metabolism.
This can lead to Hyperammonemia in some individuals.
What type of medication is Clozapine?
An atypical antipsychotic.
Clozapine is used for treatment-resistant schizophrenia and has a high risk of toxicity when combined with Depakote.
Why is the combination of Clozapine and Depakote risky?
Increases the risk of toxicity, including Hyperammonemia.
This combination can lead to severe neurological symptoms.
List the red flag signs for a patient on Depakote + Clozapine.
- Confusion or sudden mental status changes
- Nausea, vomiting
- Lethargy, tremor, stumbling
- Ammonia breath (“fishy” or urine-like)
- Elevated ammonia level on labs
What should you do if a patient presents with symptoms of Hyperammonemia?
- Check ammonia level
- Stop Depakote
- Give lactulose
- Consider switching meds
What is the mnemonic to remember the effects of Clozapine and Depakote?
Cloza + Depa = Confu-sha!
What do SNRIs affect?
Serotonin + norepinephrine.
SNRIs like duloxetine or venlafaxine are not associated with ammonia buildup.
Is the combination of SNRIs associated with ammonia buildup?
No.
If the vignette has tremor + confusion + ammonia, it indicates Depakote.
What lab should you order for a patient with bipolar disorder on Clozapine and Valproate presenting with confusion?
Ammonia level.
What is the name of the condition where Depakote causes toxic brain symptoms?
Hyperammonemia.
What do you give to clear ammonia from the body?
Lactulose.
Which medication pairing is most associated with Hyperammonemia?
Clozapine + Depakote.
True or False: Clozapine can cause Hyperammonemia when taken with Depakote.
True.
