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.