| base = Lithiumlithium| add = Valproic valproic acid

* Lithium is eliminated by and valproic acid are the kidney for about 95%most commonly used mood-stabilizing agents.<ref name="freeman">{{Pubmed|9433333|Freeman et al. Changes in the rate Mood stabilizer Combinations: A Review of excretion can cause unwanted effectsSafety and Efficacy.Am J Psychiatry 1998;155:12-21}}</ref> * Valproic acid is principally metabolized by CYP2C9, CYP2C19, CYP2A6 The combination of lithium and valproate appears to be well tolerated and UDPeffective in treating bipolar illness.<ref name="freeman"/>* Addition of valproate to lithium has been recognized as a first-glucuronosyltransferasesline treatment for mania that is refractory to lithium monotherapy. Valproic acid <ref name="freeman"/> * The addition of valproate is an inhibitor of the enzymes CYP2C9, epoxide-hydroxylase and UDP-glucuronosyltransferasesmost effective for patients with rapid cycling or mixed episodes. <ref name="freeman"/> * This combination of drugs may have possible be synergistic effects. However, this combination will also have additive side effects<ref name="freeman"/>* Lithium’s pharmacokinetics are not changed by valproate. Dose adaptation will <ref name="freeman"/>* There may be recommended for additive adverse reactions due to this combination, such as weight gain, sedation, gastrointestinal complaints, and tremor.<ref name="freeman"/>