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10.1016/j.tcb.2020.08.004 209 PaoneP.CaniP

Patients taking anticoagulants should be closely monitored for changes in prothrombin time or INR, and dosage adjustments may be necessary

(if you dont want to go down this rabbit hole, skip to the end for treatment recs) Inborn Errors of Metabolism Simply put, sometimes, initiation of valproic acid therapy leads to the unmasking of previously undiagnosed inborn errors of metabolism like urea cycle disorders, fatty acid oxidation defects, and mitochondrial disorders