* Start valproic acid according to the general dosing advice.
* 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. {{MonitorChange}}
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* Topiramate plasma levels are increased by about 15% by valproate, which could be important if valproate is withdrawn.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>