Caffeine Valproate

Noninterfering acetaminophen, acetazolamide, amphetamine, bilirubin, caffeine, diazepam, dimenhydrinate, meperidine, meprobamate, methamphetamine, methaqualone, methylphenidate, nicotine, propojcyphene, theophylline, valproate Interfering phensuximide... 

For treatment-resistant patients who do not respond to SSRIs or TCAs, or to the combination of TCAs/SSRIs with benzodiazepines, other antidepressants have shown at least some beneficial effects in alleviating PD symptoms (e.g. mirtazapine, moclobemide, nefazodone, phenelzine, reboxetine, and venlafaxine). Other agents have also been reported to exert beneficial effects in PD, especially when combined with SSRIs/TCAs (lithium, pindolol, and propranolol). In cases where all treatments have failed, valproate or olanzapine should be considered.2 - ° In order to optimize treatment, patients should avoid or reduce the consumption of compounds that could potentially induce/exacerbate panic attacks (e.g. caffeine, alcohol, and nicotine) and should exercise regularly. i... 

Phenytoin can increase the clearance of caffeine, and possibly invalidates the caffeine breath test Whether carbamazepine increases caffeine metabolism is unclear. Valproate appears not to have any effect on caffeine. 

The clearance of caffeine was about twofold higher and its half-life was reduced by about 50% in patients with epilepsy taking phenytoin, when compared with healthy subjects not taking any medications. In the same study, there were no significant differences in caffeine pharmacokinetics between healthy subjects and patients receiving carbamazepine or sodium valproate. Conversely, carbamazepine was considered to have induced the metabolism of caffeine in 5 children with epilepsy, as assessed by the caffeine breath test. In another study in healthy subjects, there was a reduction in the AUC of carbamazepine when it was given with caffeine, but caffeine had no effect on the pharmacokinetics of sodium valproate. ... 

Vaz J, Kulkami C, Joy D, Joseph T. Influence of caffeine on pharmacokinetic profile of sodium valproate and carbamazepine in normal healthy volunteers. Indian J Exp Biol (1998) 36,112-... 

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