Which medication can be safely prescribed for a client already taking Lithium?

Valproic acid, also known as Depakene, is a medication that can be safely prescribed for a client already taking lithium. Both lithium and valproic acid are mood stabilizers used to treat conditions such as bipolar disorder. They can be used concurrently under careful medical supervision, as they have different mechanisms of action. Lithium primarily helps to stabilize mood by modulating neurotransmitter levels, while valproic acid is thought to increase inhibitory neurotransmission and provide additional mood-stabilizing effects.

While careful monitoring is essential due to the potential for additive side effects and toxicity, the combination of these two medications is not uncommon in clinical practice when managing complex cases of mood disorders, particularly those with a mixed or rapid cycling presentation.

Other options, such as fluoxetine or duloxetine, which are antidepressants, can lead to potential interactions or exacerbate symptoms in some patients with bipolar disorder, especially if not adequately managed. St. John’s Wort is an herbal supplement that can also interfere with lithium levels or have unpredictable effects on mood. Therefore, valproic acid is the most suitable choice for concurrent use with lithium.