DrVirgo
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A 40-year-old woman with rapid cycling bipolar disorder is being treated with valproic acid. One month after she starts taking a second drug, her serum valproic acid concentration is decreased by 20%. Which of the following is the most likely second drug?
A) Carbamazepine
B) Diazepam
C) Haloperidol
D) Hydrochlorothiazide
E) Imipramine
F) Nifedipine
G) Propranolol
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| doc179
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A?
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| drpkaur
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hi there i think it's A-CARBAMAZEPINE becoz firstly carbamazepine is used as backup drug in bipolar disorder ,secondly carbamazepine is P450 inducer and it increases the metabolism of other anticonvulsants which means decrease in concentration of valproic acid in this case...i think i have made my self clear..any more to add...
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| robin082006
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a
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| DrVirgo
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A is right. 
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| gpsbrar
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P450 inducer is the culprit. Carbamezapine.
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