Clinical trials have shown reductions in inflammatory cytokines, improved endothelial function, and decreased oxidative stress
Research has shown this is a vagal feed-forward response, not triggered directly by stimulation to the GI tract
Answer and interpretation This is probably valproic acid induced hyperammonia encephalopathy (VHE) VHE has been reported secondary to acute VPA overdose and in chronic normal therapeutic dosing, presenting as an acute and profound decreased level of consciousness, with or without increased seizure activity this is usually in association with an increased serum ammonia level (Mock and Schwetschenau, 2008) Patients at higher risk for VHE include those with liver impairment, on multiple anticonvulsants, or have other causes of increased ammonia production
Landmark trials demonstrated significant weight loss in obese individuals
Others have variants that increase stress sensitivity, suggesting they may need more psychological support during treatment
It applies if their driving ability is impaired by alcohol or drugs
