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Combining-Topiramate-Valproic acid

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* Pharmacologic response to the drugs should be monitored more closely following addition or withdrawal of one or the other drug. Dose adjustments may be required if an interaction is suspected.
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* Topiramate has been shown to produce a small but significant increase in valproate clearance, reducing plasma levels, although enhanced valproate side-effects.
* Topiramate plasma levels are increased by about 15% by valproate, which could be important if valproate is withdrawn. <ref name=”bazire”> Bazire S, Psychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007. </ref>
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