Adding ziprasidone to valproic acid.
- 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.
- Ziprasidone is metabolized by CYP1A2 (minor) and CYP3A4.
- Start ziprasidone according to the general dosing advice.
- Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.
- Antipsychotics lower the seizure threshold and may antagonise the anticonvulsant effect of valproate. 
- Farmacotherapeutisch Kompas; Toxicologie (dutch)
- Farmacotherapeutisch Kompas - valproinezuur (dutch)
- KNMP; Informatorium Medicamentorum 2015; Monografie "valproaat" (Dutch)
- Interactions between aripiprazole and valproic acid on drugs.com
- Bazire S, Psychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007.
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