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Combining-Lamotrigine-Valproic acid

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* Reduce the lamotrigine dose by 50% of the general dose when combined with valproate. Start valproate at low dose and increase dose based on serum concentration slowly. <ref name=”medicatiebewaking”> Schalekamp T. et al, Interacties met Psychofarmaca, Stichting Health Base, Houten, 2002. </ref> <ref> {{Pubmed|8098122|Pisani at al, Interaction of lamotrigine with sodium valproate. Lancet. 1993 May 8;341(8854):1224.}}</ref>
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* Valproate can increase lamotrigine plasma levels significantly by inhibiting lamotrigine’s glucuronidation. This effect of valproate is dose-dependent.<ref name=”bazire”> Bazire S, Pshychotropic Psychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007. </ref>
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