985
It was hypothesized that valproic acid may interfere with glucuronidation of lamotrigine , leading to increased serum lamotrigine levels , or perhaps alter the drug 's metabolism , resulting in accumulation of a toxic intermediate metabolite .
 adverse effect: accumulation of a toxic intermediate metabolite, lamotrigine; adverse effect: accumulation of a toxic intermediate metabolite, valproic acid; adverse effect: increased serum lamotrigine levels, lamotrigine; adverse effect: increased serum lamotrigine levels, valproic acid
Given options, please tell me the relationships of all the listed entity pairs.Output format is "relation1: word1, word2; relation2: word3, word4". 
Option: adverse effect 
Text: {0} 
 Entity Pairs:  accumulation of a toxic intermediate metabolite, lamotrigine; accumulation of a toxic intermediate metabolite, valproic acid; increased serum lamotrigine levels, lamotrigine; increased serum lamotrigine levels, valproic acid 
Answer:
 adverse effect: accumulation of a toxic intermediate metabolite, lamotrigine; adverse effect: accumulation of a toxic intermediate metabolite, valproic acid; adverse effect: increased serum lamotrigine levels, lamotrigine; adverse effect: increased serum lamotrigine levels, valproic acid