Depakote
Question:
I just wondered if Topomax is covered by medicaid. I have gained 35 pounds so far on my meds and am desperate to lose weight. Dieting makes no difference. Right now I’m trying conjugated linoleic acid, but as yet, I see no change. Thanx for your help. Peace Starchild
Response:
Hi there Billy, I am aware of 23 other mood stabilizing medications (not including Depakote and lithium carbonate) Could you provide a list of those?
I am in the process of updating them and will post them as soon as I have finished with my MedLine search of the latest publications. Also included will be my revised conservative titration protocols for the Modern mood stabilizers (to prevent the problems caused by the PDR anticonvulsant protocols). I’ve tried 4 different stabilizers, with no great effect. I can’t tolerate Depakote at a high enough dose to be effective, so I take a smaller amount and it’s marginally effective. Neurontin has no effect on me. Lamictal gave me a systemic rash. Topamax turned me into a totally different person. It made me severely suicidal.
With some patients with BP it is just as critical HOW a mood stabilizer is prescribed as WHAT is prescribed!!! I would be willing to bet that your pdoc followed the PDR anticonvulsant protocols with you. Since these suggested (NOT required!) titration schedules are for SEIZURE Disorder – NOT BIPOLAR Disorder, many of us (approximately 25%) are incorrectly dosed with them. I was one such. The difference lies in the dosage loading (too fast) and the frequency (too infrequent) of the doses. (1) Due to Neurontin’s very short half life, it needs to be taken in equal amounts every 6 hours. Start with 100 mg capsules – rather than the 300 mg that the PDR recommends. Pregabalin (Son of Neurontin) will supersede Neurontin and will probably be FDA approved sometime in 2001. It will have improved mood stabilization, antianxiety, anti-socialization phobia, and analgesic properties as well as a much longer half life. (2) The rashes due to Lamictal can likely be avoided by starting with 25 mg tablets and slowly increasing the dose taking it BID. (Although the half life is sufficiently long to permit once daily dosing, you will likely reduce side effects by taking smaller doses more frequently.) Do not exceed 200 mg (although some can tolerate 400 mg). Apply sun blocker with a high SPF whenever out of doors in the sun. Avoid antibiotics containing penicillin derivatives. Do NOT give Lamictal to children under the age of 16. Report any rashes immediately to your doctor! In the rare event of Stevens-Johnson Syndrome rash it must be treated by a dermatologist who is familiar with it – because it can be FATAL! (3) With Topamax always start with 25 mg pills and do not divide or crush them. Slowly increase the dose BID to a maximum of 200 mg. If you exceed 200 mg, you run the risk of developing painful kidney stones. Drink plenty of water. It is a powerful appetite suppressant so it should be avoided by those who do not wish to lose weight. It has recently come to my attention that Topamax can cause an EXTREMELY SERIOUS VISION PROBLEM called: "Bilateral-Angle Closure Glaucoma" – which if not treated quickly and effectively, can lead to PERMANENT BLINDNESS! So be sure to immediately report any vision changes! For important details please be sure to read: http://www.eyeworld.org/nov00/1100p08.asp (4) I am a Great Believer in polypharmacy (the combination of two mood stabilizers) where the combined effects become greater than the sum of its constituent components. Many progressive pdocs are finding that their patients who do not respond adequately to a single mood stabilizer, are responding most favorably to this approach. There is evidently synergism involved. Depakote (divalproex sodium) commonly causes both weight gain and hair loss. I have been taking Depakote ER (extended release) for about 3 months now. Before that, I was gaining about 30 pounds in 6 months. I haven’t gained any weight since switching to the ER form. However, it should be noted that the ER form is currently approved by the FDA for use for migraines. But in my experience, it does work for bipolar.
That is not only MOST interesting – it is also MOST puzzling (assuming that you are now taking the same amount of immediate release Depakote and Depakote ER and that you are eating and exercising the same)! From my reading of:
http://www.rxabbott.com/pdf/depakote.pdf Depakene (valproic acid), Depakote (divalproex sodium), and Delayed-Release Depakote (Depakote ER) all result in the same valproate ion. The only difference is the RATE at which the disassociation process occurs. Please correct me if my understanding of the biochemistry involved is incorrect. If you further examine this 21-page document, no differentiation is made among the side effects between Depakote and Depakote ER. In fact NO MENTION WHATSOEVER is make of Depakote ER side effects! To me this implies that Abbott Laboratories does not expect any differences to be shown between the meds insofar as the side effects are concerned. One thing I found MOST strange: only 8% reported gaining weight on Depakote! See Table 2 on page 15. I would have thought that at least 50% did from the number of complaints I have read. Of course one hears more about adverse consequences than the positive ones. Perhaps nausea (31%), dyspepsia (indigestion – 13%), diarrhea (12%), vomiting (11%), and abdominal pain (9%) had something to do with keeping the test subjects’ weight gain down? Another interesting observation is that Depakote was tested and found effective for MANIA – but no mention was made of DEPRESSION. I wonder why not? It is most certainly used to treat both ends of the bipolar spectrum. Regards, Billy
Best wishes for better meds properly prescribed from, James D. Milton, Ph.D., Sc.D. — Standard Disclaimer It should be very clearly understood that I make no representations to being a physician. Any opinions stated should NOT be considered as medical advice! They are based entirely upon my education, research, personal experiences, and the experiences of numerous individuals. You should confirm any suggestions made with your physician who is SOLELY responsible for prescribing ALL medications and carefully monitoring the patient’s progress. Make NO changes in your prescribed dosage regimen without first obtaining the approval of your doctor!
Response:
I am aware of 23 other mood stabilizing medications (not including Depakote and lithium carbonate) – so your pdocs are either:
Could you provide a list of those? I’ve tried 4 different stabilizers, with no great effect. I can’t tolerate Depakote at a high enough dose to be effective, so I take a smaller amount and it’s marginally effective. Neurontin has no effect on me. Lamictal gave me a systemic rash. Topamax turned me into a totally different person. It made me severely suicidal. Depakote (divalproex sodium) commonly causes both weight gain and
hair loss. I have been taking Depakote ER (extended release) for about 3 months now. Before that, I was gaining about 30 pounds in 6 months. I haven’t gained any weight since switching to the ER form. However, it should be noted that the ER form is currently approved by the FDA for use for migraines. But in my experience, it does work for bipolar. Regards, Billy
Response:
Who is/has been on Depakote that HATES it??? I was on it once before and I hated it then, and hate it now. What are you taking instead of it??? I’m tired of the docs insisting this is all that will work with me without at least giving something else a try. I do know that my sodium level runs high anyway and they don’t want me on lithium.
I am aware of 23 other mood stabilizing medications (not including Depakote and lithium carbonate) – so your pdocs are either: (1) Not telling you the truth. Or else they (2) Are abysmally ignorant. Take your pick. Either way I strongly suggest that you get a Second Opinion from a competent pdoc (psychiatrist or psychopharmacologist)! First check to ensure that a horse and buggy is not parked out behind the office before entering! If so – you can be assured that your treatment will be commensurate with the pdoc’s mode of transportation. Depakote (divalproex sodium) commonly causes both weight gain and hair loss. To offset the former, I suggest a regular program of exercise appropriate for your age and physical condition. To counteract the latter, I suggest taking selenium tablets available OTC (Over The Counter) at any large drugstore. There is also a potential decrease in your blood platelet level – so I suggest having that monitored whenever you have your valproic acid level periodically measured. Although I sustained a moderate platelet decrease when taking Depakote, it was not nearly so severe as when I took Tegretol (carbamazepine). FYI when I took lithium and Depakote, I gained 100 pounds. I suffered significant cognitive deficits on these two meds and wound up a homeless bum living on the streets. Admittedly not everyone has such adverse reactions. Some people do quite well on Depakote and lithium. We represent opposite reaction polarities. IMO the Modern mood stabilizers (Neurontin, Lamictal, and Topamax) are light years ahead in terms of their mood stabilization effectiveness than the old mood stabilizers (lithium, Depakote, and Tegretol). In general their adverse side effects are significantly less. However the Modern meds are more expensive. But since almost all pharmaceutical companies have Patient Assistance Programs for those who do not have insurance to cover their meds, this should not be a problem. Being indigent (thanks to lithium and Depakote), I get all of my meds free of charge. FYI I take Neurontin (which restored much of my cognitive abilities) and Topamax (which is responsible for the loss of 80 of the 100 pounds that I gained on lithium and Depakote). But forever lost to me are my wife, my profession, my home, my car, my plane, all of my material possessions, etc. I now live on food stamps in a government housing project. Best wishes for better meds and better doctors from, James D. Milton, Ph.D., Sc.D. — Standard Disclaimer It should be very clearly understood that I make no representations to being a physician. Any opinions stated should NOT be considered as medical advice! They are based entirely upon my education, research, personal experiences, and the experiences of numerous individuals. You should confirm any suggestions made with your physician who is SOLELY responsible for prescribing ALL medications and carefully monitoring the patient’s progress. Make NO changes in your prescribed dosage regimen without first obtaining the approval of your doctor!
Response:
I was on depakote for all of two weeks before my doctor took me off of it because it made me worse instead of better. Everyone I have ever known who was on depakote had the zombie effect AND developed tremors that interfered with their ability to control their motor skills. That is why I call it Depakill. Also if you are on depakote remember you MUST have blood tests periodically for depokote levels in your blood and for possible liver damage. This is essential. Ralph
I think Ralph it really depends on the dosage as to what a drug will do to you. Depakote never zombified me, in fact I think I was still manic on it or off it. I didn’t have any tremors but I have seen people with them and they usually were on Lithium too. So I was always of the opinon that it was the Lithium that caused the tremors. But it could also be the combo. It’s hard to get a real assesment of what is going on when there is a combination of drugs involved. Vicky
Response:
Well I took 1000mg last night for the 1st time. The first 2 hours no diference, then all the sudden BAM! I was in bed watching TV and I felt kind of like I was asleep, yet semi awake, kind of like when you goto the Dentist and they give you that stuff where you are asleep yet paralized, kind of weird, i wanted to get up and turn on the radio "Art Bell, Coast 2 Coast am" I saw that the clock said 10pm, and wanted to get up but couldnt, I did however finally get up at 10:35. Then I went to bed and stayed asleep for 9 hours. Best night sleep ive had in years. So now Im about to take 500mg as prescribed, I hope im not sleepy today. RSS – Hide quoted text — Show quoted text -I was too tired. I am going to give it another try though as I had also recently switched from cipramil to efexor and had lost my appetite on the efexor. My doctor says I mustn’t lose any more weight. I don’t know if the tiredness was due to not eating enough so thought over Christmas I might try the depakote again. Good luck if you do try it and let me know how you do:)
Response:
- Hide quoted text — Show quoted text – Hello people, I’ll make this quick… 1. 5 years Dr’s thought i had ADD and Major Depression 2. Dr. Takes me off Dexedrine, keeps me on Celexa and Adds Strattera 3. Strattera induces a Manic State <Never had before 4. Dr. Says Manic state due to Strattera should not have happeded, so he now say im BI-POLAR 5. Dr. puts me on Zyprexa <Gained 26 Pounds in 2 weeks, makes me feel like crap, Dr. puts me on Risperdol. 6. No longer in manic state 7. Dr. Keeps me off Celexa and everything else and now prescribes Depakote 500mg, 1 AM , 2 before bedtime. What should I expect from Depakote? Will I be a zombie, and non functinal like with Reperdol? If I am a Zombie will I start playing games lime Resident Evil on Playstation? <just a stupid joke Thanks Randy
Hiya, Well I recently switched from carbamazepine to depakote (500mgs twice a day) and after 2 weeks I stopped as I couldn’t function properly as I was too tired. I am going to give it another try though as I had also recently switched from cipramil to efexor and had lost my appetite on the efexor. My doctor says I mustn’t lose any more weight. I don’t know if the tiredness was due to not eating enough so thought over Christmas I might try the depakote again. Good luck if you do try it and let me know how you do:)
Response:
7. Dr. Keeps me off Celexa and everything else and now prescribes Depakote 500mg, 1 AM , 2 before bedtime. What should I expect from Depakote? Will I be a zombie, and non functinal like with Reperdol?
I hope not and I doubt it. Resperidol is a anti psychotic and has a very different side effect profile. Depakote is a anti convulsant, it is also used to treat people with seizure disorder… It might make you a little sleepy in the afternoon, but all and all doesn’t really change the essential you. I would think you would have to have a whooping dose in order for it to zombify you. I have switched to Lamictal and it seems to be a little better for me. It seems I am a little clearer, but that could be just total circumstance too. Take care, Vicky
Response:
Hello people, I’ll make this quick… 1. 5 years Dr’s thought i had ADD and Major Depression 2. Dr. Takes me off Dexedrine, keeps me on Celexa and Adds Strattera 3. Strattera induces a Manic State <Never had before 4. Dr. Says Manic state due to Strattera should not have happeded, so he now say im BI-POLAR 5. Dr. puts me on Zyprexa <Gained 26 Pounds in 2 weeks, makes me feel like crap, Dr. puts me on Risperdol. 6. No longer in manic state 7. Dr. Keeps me off Celexa and everything else and now prescribes Depakote 500mg, 1 AM , 2 before bedtime. What should I expect from Depakote? Will I be a zombie, and non functinal like with Reperdol? If I am a Zombie will I start playing games lime Resident Evil on Playstation? <just a stupid joke Thanks Randy
Response:
You should be getting blood tests to tell you when you reach therapeutic blood levels of this drug. Every body handles the dosage differently, and you blood levels can vary even based on other drugs you are taking. It took me a few months to get to therapeutic levels of depakote. Diane
– Hide quoted text — Show quoted text – My doctor put me on Depakote this past Friday and Wednesday raised me from 2 per day to 3. They’re the 250 Depakote ER. Can anyone tell me, how much more will I have to take? How much higher does it get? This is my first time ever taking a mood stabilizer. Rose
Response:
permanently into the ether: My doctor put me on Depakote this past Friday and Wednesday raised me from 2 per day to 3. They’re the 250 Depakote ER. Can anyone tell me, how much more will I have to take? How much higher does it get? This is my first time ever taking a mood stabilizer. Rose
Hi Rose and Welcome to ASDMM. Any medication usually starts out with a lower dose and you work up to a therapeutic dose. Everyone is different. What works for you may not work for me or other people. Medication is a trial and error thing and it can take a while to find the right combo and doses for you. You are on your first medication–most of us go through many medications over the years–so think of it as a journey and a science experiment. What is going to work best for you with the least side effects. Keep a journal so you can keep track of changes. HTH, Nancy Just knockin’ around the zoo. (James Taylor)
Response:
– Hide quoted text — Show quoted text – permanently into the ether: My doctor put me on Depakote this past Friday and Wednesday raised me from 2 per day to 3. They’re the 250 Depakote ER. Can anyone tell me, how much more will I have to take? How much higher does it get? This is my first time ever taking a mood stabilizer. Rose Hi Rose and Welcome to ASDMM. Any medication usually starts out with a lower dose and you work up to a therapeutic dose. Everyone is different. What works for you may not work for me or other people. Medication is a trial and error thing and it can take a while to find the right combo and doses for you. You are on your first medication–most of us go through many medications over the years–so think of it as a journey and a science experiment. What is going to work best for you with the least side effects. Keep a journal so you can keep track of changes. HTH, Nancy Just knockin’ around the zoo. (James Taylor)
Very good advice Nancy, Ive gone through med changes since my 6 year struggle. Finally Im on good meds and happy 
Journals are very good I started with my new doc to keep one.
Response:
My doctor put me on Depakote this past Friday and Wednesday raised me from 2 per day to 3. They’re the 250 Depakote ER. Can anyone tell me, how much more will I have to take? How much higher does it get? This is my first time ever taking a mood stabilizer. Rose
Response:
My doctor put me on Depakote this past Friday and Wednesday raised me from 2 per day to 3. They’re the 250 Depakote ER. Can anyone tell me, how much more will I have to take? How much higher does it get? This is my first time ever taking a mood stabilizer. Rose
Well after a while you will have blood tests to make sure the depakote is not toxic to your system, basicly in my use of depakote the ranges of drug varies, best of luck on your new med…….
Response:
Related Posts
- glaucoma meds and preg. ?
- I'm Nervous - Abstaining From Pain Relief
- Chat support group update!
- open-angle
- chat group update