Depakote and Lamictal in children

Using depakote and lamictal together raises the question of the drug interaction between the two. Can it be used safely? Yes it can. I prefer to start the depakote first and titrate it to a therapeutic dose. Then start lamictal at 5mg per day and gradually titrate up by 5mg per week. It is important to know that you will have much higher levels of lamictal at smaller doses. The advantage is that you can reach therapeutic levels sooner. The combination can be effective in treating mood disorders that don't respond to a single mood stabilizer. Be careful and watch for rashes, especially Stevenson Johnson syndrome.