Gamma-hydroxybutyrate (ghb) - Depakote (Divalproex Sodium) Interaction
Herbal: Gamma-hydroxybutyrate (ghb)
Drug: Divalproex Sodium
Brand names:
Depakote

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 25, 2025
Interaction Details
Divalproex Sodium is classified as belonging to the following category: Cns Depressants
GHB may increase the risk of serious CNS and respiratory depression.
Concomitant use of GHB with CNS depressants may increase the risk of serious CNS and respiratory depression.
Interaction Rating
Likelihood of Occurrence
ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
References
- Product information for Xyrem. Jazz Pharmaceuticals, Inc. Palo Alto, CA. March 2022.
Interaction Details
Divalproex Sodium is classified as belonging to the following category: Anticonvulsants
Theoretically, GHB may reduce the effects of anticonvulsant medications.
GHB has been reported to cause seizures, and may theoretically reduce the effectiveness of anticonvulsants. Also, concomitant use of GHB with sedative anticonvulsants may increase the risk of serious CNS and respiratory depression.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Anon. Multistate outbreak of poisonings associated with illicit use of gamma hydroxy butyrate. JAMA 1991;265:447-8.
- Stomberg MW, Knudsen K, Stomberg H, Skärsäter I. Symptoms and signs in interpreting gamma-hydroxybutyrate (GHB) intoxication - an explorative study. Scand J Trauma Resusc Emerg Med. 2014 Apr 23;22:27.
- Product information for Xyrem. Jazz Pharmaceuticals, Inc. Palo Alto, CA. March 2022.
Interaction Details
Divalproex Sodium is classified as belonging to the following category: Divalprox Sodium (Depakote)
Divalproex sodium can increase the levels and clinical effects of GHB.
Concomitant use of GHB with divalproex sodium may increase the plasma levels and clinical effects of GHB. Concomitant use of the prescription form of GHB (sodium oxybate) with valproic acid results in approximately 25% increased exposure to GHB. It is recommended that the dose of the prescription form of GHB (sodium oxybate) be decreased by at least 20% if divalproex sodium is initiated in patients already receiving GHB (sodium oxybate) and that a lower starting dosage of GHB (sodium oxybate) is used in patients who are already receiving divalproex sodium.
Interaction Rating
Likelihood of Occurrence
LikelyWell-controlled human studies have demonstrated the likely existence of this interaction
References
- Product information for Xyrem. Jazz Pharmaceuticals, Inc. Palo Alto, CA. March 2022.
Divalproex Sodium Overview
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Valproic acid is used alone or with other medications to treat certain types of seizures. Valproic acid is also used to treat mania (episodes of frenzied, abnormally excited mood) in people with bipolar disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). It is also used to prevent migraine headaches but not to relieve headaches that have already begun. Valproic acid is in a class of medications called anticonvulsants. It works by increasing the amount of a certain natural substance in the brain.
Gamma-hydroxybutyrate (ghb) - More Interactions
Gamma-hydroxybutyrate (ghb) interacts with 272 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
Unknown | No interactions have been reported or no interaction data is currently available. |
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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Drug descriptions are provided by MedlinePlus.