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What to do if a patient develops thrombocytopenia during treatment with valproate

One of my outpatients with bipolar disorder had complete remission from mood episodes after being treated with divalproex (Depakote® ER). But, many months later, the family contacted me due to concern about a low platelet count during routine laboratory monitoring. See the image below. The serum valproic acid level was at the lower end of…

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