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The triple agonist mechanism wasnt the villain - it was cumulative exposure and high doses

The abdomen, thigh, and upper arm are common injection sites

Conversely, Hantson and coworkers [83] recently reported the case of a 47-year-old epileptic man in whom parenteral VPA therapy was associated with a severe hyperammonaemic encephalopathy (peak ammonia concentration 411 mol/l) without any biological signs of hepatotoxicity