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There are several case reports of valproic acid initiation leading to increased seizures and encephalopathy (without hyperammonemia), resulting in cautions against using valproic acid in patients with known mitochondrial disorders like mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS)

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There arent set timelines for this, and experiences vary

This standardization emerged from the pivotal clinical trials that established both efficacy and safety profiles