What should we do about valproate-induced macrocytosis?

Question from a Member: When a patient develops macrocytosis secondary to divalproex (Depakote®) use, at what point should discontinuation of divalproex be considered? For a brief introduction to macrocytosis, please see the following article on this website: Macrocytosis: A brief summary for mental health clinicians Hematological side effects of valproate It is well-known that valproate…