Valproic Acid Intoxication EMCrit Project Pet Clinique Cardio Support L Carnitine as an off label use for VALPROIC ACID TOXICITY HOW AND WHY? Valproic acid may interrupt fatty acid metabolism, impairing mitochondrial function and ultimately urea metabolism, leading to Raghad Altelly Valproic Acid Toxicity When the calmer becomes the culprit In the ICU, some tox cases whisper and some unravel like a metabolic domino cascade. Valproate toxicity belongs to the latter. Summary of Cases of L Carnitine for Valproic Acid Overdose Download Table