Sodium valproate can apparently lower serum clozapine and olanzapine levels. The combination of olanzapine and valproate appears to increase the risk of hepatic injury in children.
Monitor the levels of clozapine and adjust the dose as necessary. With olanzapine, it has been suggested that liver enzymes should be monitored every 3 to 4 months for the first year of treatment, thereafter monitoring every 6 months if no adverse effects are detected.
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