Mood Emot 2022 Nov; 20(3): 65-67   https://doi.org/10.35986/me.2022.20.3.65
Case of Decreased Serum Valproic Acid Concentration During Concomitant Use of Meropenem in Patients with Traumatic Brain Injury
Chan-Kyu Jeong , MD, Chan-Mo Yang , MD, Sang-Yeol Lee , MD, PhD, Seung-Ho Jang , MD
Departement of Psychiatry, Wonkwang University School of Medicine, Iksan, Korea
Correspondence to: Seung-Ho Jang, MD
Department of Psychiatry, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan 54538, Korea
TEL +82-63-859-1044 FAX +82-63-857-1043 E-mail psychicjang@gmail.com ORCID https://orcid.org/0000-0002-3479-0552
Received: November 18, 2022; Accepted: November 21, 2022; Published online: November 30, 2022.
© Korean Society for Affective Disorders. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Blood valproic acid levels were decreased in patients with traumatic brain injury who had been using valproic acid to control irritability and aggression, and the symptoms worsened coincident with the administration of meropenem, a carbapenem-based antibiotic. Two weeks after the discontinuation of meropenem, valproic acid levels were restored to an effective therapeutic concentration. Therefore, when valproic acid and carbapenem-based antibiotics are used together, blood valproic acid levels may decrease due to drug interaction, and irritability symptoms may worsen. Thus, close monitoring of serum valproic acid levels is required.
Keywords: Valproic acid; Meropenem; Traumatic brain injury; Impulsive behavior

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