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 Carnitine Acylcarnitine Translocase Deficiency an overview ScienceDirect Topics L Carnitine in the Treatment of Psychiatric and Neurological Manifestations: A Systematic Review Hyperammonemia in Inherited Metabolic Diseases Cellular and Molecular Neurobiology Springer Nature Link
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l-carnitine and ammonia levels Reversible weakness and encephalopathy while on long-term valproate treatment due to carnitine deficiency