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Concurrent use of clozapine and valproate in affective and psychotic disorders
J C Kando1, M Tohen, J Castillo
1Pharmacoepidemiology Center, McLean Hospital, Belmont, Mass. 02178.
Background:
This pharmaco-epidemiologic study was undertaken to determine if the combination of clozapine and valproate poses an increased risk of blood dyscrasias, liver function abnormalities, or other side effects and to develop dosing guidelines when the combination is utilized.
Method:
The charts of 55 patients receiving clozapine and valproate concurrently between May 8, 1989, and May 8, 1992, were reviewed to determine the indication for and length of time on each medication, abnormalities in liver function test results, blood cell dyscrasias, seizures, nausea, vomiting, sedation, sialorrhea, and enuresis. In addition, the efficacy of the combination was measured.
Results:
The combination of clozapine and valproate was efficacious and well tolerated in the majority of patients. Major adverse effects such as blood dyscrasias or seizures were not experienced by the study population. The side effect that led to discontinuation of the combination most frequently was sedation.
Conclusion:
The combination of clozapine and valproate is safe and efficacious.