{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:27:52Z","timestamp":1792798072818,"version":"4.5.0"},"reference-count":72,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2014,6,1]],"date-time":"2014-06-01T00:00:00Z","timestamp":1401580800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Strategic Educational Pathways Scholarship"},{"name":"European Union \u2013 European Social Fund","id":[{"id":"https:\/\/ror.org\/019w4f821","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The anticonvulsant valproic acid and the atypical antipsychotics olanzapine and quetiapine provide synergistic mood-stabilising, antidepressant and antipsychotic activities in the treatment of bipolar and schizoaffective disorders. Existing literature shows that pharmacokinetic and pharmacodynamics drug\u2013drug interactions (DDIs) possibly occur with the use of such a combination. Clinical reports of a possible interaction between the drugs leading to an increased risk of adverse drug reactions have also emerged. The main objective of this paper is to review the incidence of DDIs between the anticonvulsant and the antipsychotics, to postulate the possible mechanisms of the interaction and to establish whether certain target populations are at an increased susceptibility to such interactions. The usefulness of therapeutic drug monitoring (TDM) of the antipsychotics to monitor for an interaction was also assessed. A systematic database search was carried out using the search engine provided by PubMed using the following key words: olanzapine, quetiapine, valproic acid, pharmacokinetic drug\u2013drug interaction, bipolar disorder, therapeutic drug monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key findings<\/jats:title>\n                    <jats:p>Evidence of a possible clinically relevant DDI between valproic acid and both antipsychotics has been uncovered. A possible mechanism for the interactions has been postulated, and the importance of TDM has been discussed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Further research is required to determine whether DDIs occur with the concurrent use of valproic acid and olanzapine or quetiapine, and to investigate the potential of TDM as a clinical tool in improving pharmacotherapy and preventing toxicity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jphp.12209","type":"journal-article","created":{"date-parts":[[2014,1,7]],"date-time":"2014-01-07T05:23:01Z","timestamp":1389072181000},"page":"747-759","source":"Crossref","is-referenced-by-count":19,"title":["Interactions between valproic acid and quetiapine\/olanzapine in the treatment of bipolar disorder and the role of therapeutic drug monitoring"],"prefix":"10.1093","volume":"66","author":[{"given":"Thomas","family":"Vella","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics, University of Malta , Msida,","place":["Malta"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Mifsud","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics, University of Malta , Msida,","place":["Malta"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,6,1]]},"reference":[{"key":"2024103109150058800_jphp12209-cit-0001","first-page":"749","article-title":"Olanzapine approved for the acute treatment of schizophrenia or manic\/mixed episodes associated with bipolar I disorder in adolescent patients","volume":"6","author":"Maloney","year":"2010","journal-title":"Neuropsychiatr Dis 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