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This is not a sign that the medication is failingrather, your body has adjusted to the new physiological state
Reduced serum free carnitine as well as reduced levels of 3-keto-VPA, the main metabolite of -oxidation of VPA, was first reported in 1982 by Bohles and coworkers [53] in a 3-year-old girl who developed acute liver disease with typical features of Reye's syndrome after treatment with VPA for 6 months
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