Combining-Lithium-Valproic acid
| ||||||||||||||||||||||||||||||||||
| ||||||||||||||||||||||||||||||||||
Adding valproic acid to lithium.
General information- Lithium is eliminated by the kidney for about 95%. Changes in the rate of excretion can cause unwanted effects.
- 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 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 valproate to lithium has been recognized as a first-line treatment for mania that is refractory to lithium monotherapy.[4]
- The addition of valproate is most effective for patients with rapid cycling or mixed episodes.[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]
Start valproic acid- Start valproic acid according to the general dosing advice.
- ↑ 1.0 1.1 Farmacotherapeutisch Kompas - lithium (dutch)
Cite error: Invalid
<ref>tag; name "ftk" defined multiple times with different content - ↑ Farmacotherapeutisch Kompas; Toxicologie (dutch)
- ↑ KNMP; Informatorium Medicamentorum 2023; Monografie "valproaat" (Dutch)
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21
The editors of psychiatrienet.nl take the greatest care to provide up-to-date and accurate information on this site. Nevertheless, mistakes and omissions cannot be entirely excluded. No rights devolve from the information provided. The editors and other providers of information to this site accept no responsibility for the content of this site or for the information provided therein; neither do they accept responsibility for possible damages which may derive from the use of the information on this site or from the linked sites. The editorial board accepts no responsibility for the content of the (linked) sites, for access to them, or for the products and services on these sites, nor for the occurrence of errors, viruses, and/or disruptions in service.