Prior to the initiation of valproic acid therapy, evaluation for UCD should be considered in the following patients: 1) those with a history of unexplained encephalopathy or coma, encephalopathy associated with a protein load, pregnancy-related or postpartum encephalopathy, unexplained mental retardation, or history of elevated plasma ammonia or glutamine
Private insurance plans increasingly cover these medications for approved indications, though often with requirements like prior authorization, step therapy, or documented failed attempts at lifestyle modification
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Unfortunately, over 90% of the reports lacked detailed information on patients weight and outcomes