Amitriptyline and nortriptyline
plasma levels can be increased by sodium
valproate. Status epilepticus has been attributed to elevated clomipramine levels in a patient taking valproic acid.
It would seem prudent to monitor for tricyclic adverse effects (such as dry mouth, blurred vision and urinary retention) and reduce the dosage of the tricyclic if necessary.
Tricyclics can lower the convulsive threshold and should therefore be used with caution in patients with epilepsy.