* Valproic Lithium and valproic acid is principally metabolized by CYP2C9, CYP2C19, CYP2A6 are the most commonly used mood-stabilizing agents.<ref name="freeman">{{Pubmed|9433333|Freeman et al. Mood stabilizer Combinations: A Review of Safety and UDPEfficacy. Am J Psychiatry 1998;155:12-glucuronosyltransferases21}}</ref> * The combination of lithium and valproate appears to be well tolerated and effective in treating bipolar illness. Valproic <ref name="freeman"/>* Addition of lithium to valproic acid is an inhibitor the treatment of the enzymes CYP2C9, epoxide-hydroxylase and UDP-glucuronosyltransferaseschoice for acute mania with partial but inadequate response to valproate.<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"/>