Combining-Lithium-Valproic acid

Lithium
Type moodstabilizer
Group other
links
ATC-code N05AN01
Medscape Lithium
PubChem 11125
PubMed Lithium
Drugs.com lithium
Kompas (Dutch) Lithium
Wikipedia Lithium
Valproic acid
Type moodstabilizer
Group anticonvulsant
links
ATC-code N03AG01
PubChem 3121
PubMed acid%22 Valproic acid
Drugs.com valproic-acid
Kompas (Dutch) Valproic acid
Wikipedia Valproic acid

Adding valproic acid to lithium.

Infobord.png General information
  • Lithium is eliminated by the kidney for about 95%. Changes in the rate of excretion can cause unwanted effects.
  • Valproic acid is principally metabolized by CYP2C9, CYP2C19, CYP2A6 and UDP-glucuronosyltransferases. Valproic acid is an inhibitor of the enzymes CYP2C9, epoxide-hydroxylase and UDP-glucuronosyltransferases.
  • Lithium and valproic acid are the most commonly used mood-stabilizing agents.[4]
  • The combination of lithium and valproate appears to be well tolerated and effective in treating bipolar illness.[4]
  • Addition of valproate to lithium has been recognized as a first-line treatment for mania that is refractory to lithium monotherapy.[4]
  • The addition of valproate is most effective for patients with rapid cycling or mixed episodes.[4]
  • This combination may be synergistic.[4]
  • Lithium’s pharmacokinetics are not changed by valproate.[4]
  • There may be additive adverse reactions due to this combination, such as weight gain, sedation, gastrointestinal complaints, and tremor.[4]
Eenrichtingbord.png Start valproic acid
  • Start valproic acid according to the general dosing advice.



  1. ↑ 1.01.1 Farmacotherapeutisch Kompas - lithium (dutch) Cite error: Invalid <ref> tag; name "ftk" defined multiple times with different content
  2. ↑ Farmacotherapeutisch Kompas; Toxicologie (dutch)
  3. ↑ KNMP; Informatorium Medicamentorum 2015; Monografie "valproaat" (Dutch)
  4. ↑ 4.04.14.24.34.44.54.6 Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21
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