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Concentrations greater than 850mg/L (6000micromol/L) are associated with severe poisoning .ref5 Correlation of Clinical Effects with VPA levels: 850mg/L: greatest risk for serious or life-threatening effects including coma, respiratory depression, metabolic acidosis, hypotension There have been cases of inaccurate valproate level measurements in severe overdoses because samples were not diluted before measurement write on the laboratory order form suspected valproate overdose and the likely ingested dose so that laboratory staff are aware

Those fluctuations accelerate every degradation pathway

This complementary signaling allows both pathways to be active simultaneously without receptor competition

They function as a team