22 November 2025
: Case report 
Sodium Valproate-Associated Thrombocytopenia in Antiepileptic Drug Polypharmacy: A Case Report and Review of the Literature
Diagnostic / therapeutic accidents, Adverse events of drug therapy
Xuehua Deng CEF 1, Xinyi Tu CEF 1, Shiwen Yang BD 1, Jianghong Xiong BD 1, Yuanjian Yang ADFG 1,2, Shuzhen Jiang ABD 1,2*DOI: 10.12659/AJCR.949595
Am J Case Rep 2025; 26:e949595
Table 3 Naranjo Scale for valproate.
| Question | Yes | No | Do not know | Score |
|---|---|---|---|---|
| 1. Are there previous conclusive reports of this reaction? | +1 | 0 | 0 | +1 |
| 2. Did the adverse event appear after the suspected drug was administered? | +2 | −1 | 0 | +2 |
| 3. Did the adverse reaction improve when the drug was discontinued or a specific antagonist was administered? | +1 | 0 | 0 | +1 |
| 4. Did the adverse reaction reappear when the drug was readministered? | +2 | −1 | 0 | 0 |
| 5. Are there alternative causes (other than the drug) that could independently have caused the reaction? | −1 | +2 | 0 | −1 |
| 6. Did the reaction reappear when a placebo was given? | −1 | +1 | 0 | 0 |
| 7. Was the drug detected in the blood (or other fluids) at concentrations known to be toxic? | +1 | 0 | 0 | +1 |
| 8. Was the reaction more severe when the dose was increased, or less severe when the dose was decreased? | +1 | 0 | 0 | +1 |
| 9. Did the patient have a similar reaction to the same or similar drugs during any previous exposure? | +1 | 0 | 0 | 0 |
| 10. Was the adverse event confirmed by any objective evidence? | +1 | 0 | 0 | +1 |