Combining-Valproic acid-Lithium

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Valproic acid
Type moodstabilizer
Group anticonvulsant
links
ATC-code N03AG01
PubChem 3121
PubMed acid%22 Valproic acid
Drugs.com valproic-acid
Kompas (Dutch) Valproic acid
Wikipedia Valproic acid
Lithium
Type moodstabilizer
Group other
links
ATC-code N05AN01
Medscape Lithium
PubChem 11125
PubMed Lithium
Drugs.com lithium
Kompas (Dutch) Lithium
Wikipedia Lithium

Adding lithium to valproic acid.

Infobord.png General information
  • Valproic acid is principally metabolized by CYP2C9, CYP2C19, CYP2A6 and UDP-glucuronosyltransferases. Valproic acid is an inhibitor of the enzymes CYP2C9, epoxide-hydroxylase and UDP-glucuronosyltransferases.
  • Lithium is eliminated by the kidney for about 95%. Changes in the rate of excretion can cause unwanted effects.
  • Lithium and valproic acid are the most commonly used mood-stabilizing agents.[4]
  • The combination of lithium and valproate appears to be well tolerated and effective in treating bipolar illness.[4]
  • Addition of lithium to valproic acid is the treatment of choice for acute mania with partial but inadequate response to valproate.[4]
  • This combination may be synergistic.[4]
  • Lithium’s pharmacokinetics are not changed by valproate.[4]
  • There may be additive adverse reactions due to this combination, such as weight gain, sedation, gastrointestinal complaints, and tremor.[4]
Eenrichtingbord.png Start lithium
  • Start lithium acid according to the general dosing advice.



  1. Farmacotherapeutisch Kompas; Toxicologie (dutch)
  2. 2.0 2.1 Farmacotherapeutisch Kompas - valproinezuur (dutch) Cite error: Invalid <ref> tag; name "ftk" defined multiple times with different content
  3. KNMP; Informatorium Medicamentorum 2023; Monografie "valproaat" (Dutch)
  4. 4.0 4.1 4.2 4.3 4.4 4.5 Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21
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