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Adding risperidone to valproic acid.
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.
- Risperidone is principally metabolized by CYP2D6 to an active metabolite 9-OH-risperidone (paliperidone).
- 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.
- Risperidone is principally metabolized by CYP2D6 to an active metabolite.
- This combination of drugs may have possible synergistic effects. However, this combination will also have additive side effects. Dose adaptation will be recommended for this combination.
Start risperidone- Coadministration with risperidone may alter the serum concentrations of valproic acid, although data are conflicting.
- Start according to the general dosing advice. Monitoring of the pharmacologic response and serum valproate levels is recommended. [6]
Cave- Dose-related generalised oedema is reported. [7]
- Antipsychotics lower the seizure threshold and may antagonise the anticonvulsant effect of valproate. [8]
- ↑ Farmacotherapeutisch Kompas; Toxicologie (dutch)
- ↑ Farmacotherapeutisch Kompas - valproinezuur (dutch)
- ↑ 3.0 3.1 3.2 KNMP; Informatorium Medicamentorum 2023; Monografie "valproaat" (Dutch)
Cite error: Invalid
<ref>tag; name "informatorium" defined multiple times with different content - ↑ Woods SW; Chlorpromazine equivalent doses for the newer atypical antipsychotics J Clin Psychiatry 2003;64:663-667
- ↑ 5.0 5.1 The Lundbeck Institute; Psychotropics; Terminal Plasma Half-lives
- ↑ Drugs.com olanzapine
- ↑ Sanders and Lehrer, Edema associated with addition of risperidone to valproate treatment. J Clin Psychiatry. 1998 Dec;59(12):689-90.
- ↑ Bazire S, Psychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007.
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