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  1. Hello everyone! So, this is more exploratory than anything. I accept that, as someone with bipolar disorder, taking an antipsychotic might be a necessary part of my maintenance treatment, and lately that has become more evident. I had been taking Rexulti (brexpiprazole) in varying doses since 2017 when I started it with Depakote ER (divalproex, 24-hour) and Trintellix (vortioxetine). Still taking the Depakote (now up to 1500mg), but Trintellix and Rexulti have worked their way out of the equation, as of late. My medication regimen has taken a more classical turn due to a breakthrough hypomanic episode in Dec./Jan., and I am currently taking a combo of Depakote ER at night along with 0.5mg of Risperdal (risperidone). Because of persistent issues with depression and anxiety, I am also now taking 50mg of Pristiq (desvenlafaxine) each morning along with 50mg of Vyvanse (lisdexamfetamine) for ADHD that I have been taking for some time. This combo seems to be working fairly well for me. When I started the Risperdal at 0.25mg/day at bedtime, I didn't really notice much difference at all during the day, but I suppose it was nice as a sleep aid. I increased to 0.5mg on Day 4 and I've parked here to try it out for a bit before deciding to increase further. The Risperdal is really to deal with those breakthrough hypomanic/mixed symptoms such as irritability and agitation, which have always been tough for me. In the beginning of my treatment (2014), antipsychotics were used as monotherapy for mood stabilization, but I could never tolerate the doses necessary to calm those symptoms, because I was easily susceptible to EPS like akathisia. Fast-forward a few years, and we've found that using an anticonvulsant as the primary mood stabilizer with the antipsychotic as a secondary has generally served me well without too much incidence of akathisia. I started Risperdal on June 8th and increased to 0.5mg a few days afterward. So it's been almost 3 weeks at this dose. My experience so far tells me to keep increasing. I'm curious to know people's experiences on Risperdal, particularly in combination with another established mood stabilizing agent like lithium or valproate. I recognize that I take Depakote and that a combo of lithium+Risperdal may not be the same, but the mood stabilizing effects of lithium and valproate are generally regarded with equal respect in most literature for the time being. Any thoughts on lower dose Risperdal?....particularly in concert with another mood stabilizer?
  2. Doctor has me on 200mg Lamictal [100mg bid] & 750 mg Depakote [250mg tid] When I when to the pharmacy, they said there was a RED ALERT. I know that Depakote decreases the clearance of Lamictal, my question is by how much? Anyone know? Does the dosage of Depakote matter? Like if I went to 1000mg of Depakote would that increase my Lamictal level even more?
  3. Hi, Does anyone taking Depakote go for a 3-month blood test, specifically to test the Depakote levels in your blood? I took Depakote about 6 years ago and I don't remember ever having to take a blood test to measure the Depakote levels in my blood. I remember being extremely tired on Depakote, to where I couldn't stay awake during the day even after a full night's sleep, and even after drinking caffeine. However, I go to a different psychiatrist now, and she told me on Depakote I would need to have my blood tested every 3 months to measure the Depakote level in my body. I was thinking that maybe I was so extremely tired on Depakote years ago was because I may have had too much of it in my body, because I didn't get any blood tests done for Depakote levels.
  4. Towards the end of August of this year and the beginning of this month, I was a bit manic, and then on 9/5/18, I saw my pdoc, and she put me on divalproex sodium ER (Depakote ER) 500 mg every morning and olanzapine (Zyprexa) 10 mg as needed for mania. Since starting the Depakote, I've already noticed that I am feeling rather flat and unmotivated, and that I'm slowly becoming depressed. It's been about four days into taking the Depakote, not long really, but I'm a little alarmed. A good friend of mine who's very knowledgeable with medications said that this is a very small dose, and I deduced that I would not feel much of anything, but I'm wondering if I'm sensitive to the anti-manic effects of it and that it might be putting me "too far on the other side" of euthymia... Does anyone maybe have any insight on this, or has anyone maybe even experienced this same thing? Could this possibly be the Depakote this quickly into taking it, or is this maybe just "post-manic depression," or what? I've also been taking the olanzapine (Zyprexa) nightly since it was prescribed to me to make sure I get good sleep, as getting good sleep was one of the things my pdoc instructed me to do since the main thing that precipitated my manic episode was lack of sleep. This probably confounds the clinical picture a bit, but I figured I would mention this. Any input would be much appreciated. Thanks!
  5. I have been a long time user of depakote, over 15 years and while it has done a fantastic job of helping to stabilize my moods, with the addition of geodon, I am unhappy with the major hair loss it has caused. My pdoc has recommended either lithium or vraylar as a substitute. Has anyone switched to either of these two meds from depakote? What are your experiences? Side effects? I am anxious to stop the hair loss but am afraid to give up the stability I have. Another concern is weight gain. I have recently lost 75 pounds of seroquel weight and am in no hurry to gain it back. I have bipolar disorder with psychotic episodes that is currently well controlled. Any suggestions?
  6. Does anyone have any experience specifically with the Depakote+Lamictal combo (with or without other medications). I've been on Depakote now since about November of last year but we're swapping out the Trintellix for Lamictal because my new insurance in July might give me a hard time about covering Trintellix. And we (my pdoc and I) figured that demonstrating an approved medication doesn't work (if it doesn't work that is) should be something we should try before submitting the step therapy paperwork for Trintellix. For this new insurance, they not only require that you try at least two other generics, but the "Restricted Access" meds also are only allowed to be used for FDA approved indications (i.e. Trintellix is approved for MDD but I'm BP2). I started Lamictal on Thursday. 25mg every other day for 2 weeks. Then 25mg every day for two weeks. Then we'll decide if we want to increase it again to 50mg for another two weeks or if we want to increase the Depakote or Rexulti. I don't recall Lamictal having such a difficult startup when it comes to GI discomfort. I remember the antsy almost anxious feeling, and I remember the headaches, but I'm also having nausea, some mild stomach cramping, diarrhea, but fortunately no vomitting. Has anyone else ever taken Depakote and started Lamictal and found they had a hard time. Better yet has anyone ever taken Lamictal both with AND without Depakote and found it less tolerable when taken with Depakote? I am aware of the medication interaction between these two meds. So I know that Depakote is going to increase Lamictal blood levels and might amplify some of these side effects. It's just more difficult than I remembered from the last time I took it years ago when I wasn't on Depakote and I wasn't really expecting it to be this much worse. Granted, I've only taken two doses at this point. So I might be jumping the gun and might find that I feel better later this week. But I'm also supposed to be discontinuing the Trintellix on Thursday. And if I'm still having a hard time adjusting to the Lamictal, stopping Trintellix at the same time could make me miserable, and I know that. Anyone have two cents?
  7. Hey guys. I’ve been pretty stable on Depakote, but it sure does come with some undesirable side effects. Somehow it makes me feel overwhelmed. It’s kind of a brain fog 2.0 feeling. Also it haven’t helped much with my anxiety, and there’s still some depression left too. I’m also on 2 antidepressants and a small dose of gabapentin, with no luck. What are your experiences with lithium or seroquel? I do not want to feel like a zombie and also do not want to feel too flat or foggy
  8. Hey! Just started Depakote 200 mg 5 days ago. Started getting really depressed and anxious on it right away and it’s only getting worse. Anyone else experienced this? Does it get better with time? Thinking it might be a start-up side effect, but i worry it’s going to continue. A lot of drugs in the same class have made me depressed in the past. Lamotrigine, lyrica, gabapentin, trileptal...
  9. Hi, Recently my care team has noticed some changes in myself and the current consensus is that I may have went from depressive type to bipolar type of schizoaffective disorder. These changes progressed over the course of a year (but I have been flat out diagnosed for over 4 years, the type of illness has changed over time). I went from schizophrenic to schizoaffective depressive, and now it's possible I became bipolar type (as everyone has seen me pretty much every day, minus him, and noticed these changes that I noticed as well). The thing is that I am already on a unique regimen which the medications in theory should be helping my manic/hypomanic states (though I ended up on them as a depressive type). I take abilify maintena once every 4 weeks and invega trinza every 12 weeks (injections). My doctor discontinued my SNRI (effexor). He is letting me decide what I feel is better to do in this situation given that I am on a unique regimen and yet my hypomanic/occasional full blown mania states are coming up regardless. Of course, he still has a final say. He gave me some guidelines to look at to get an idea and discuss what I'd like to do at my next appointment. Since I was on carbamazepine (tegretol) in the past when my dx was very "not otherwise specified" I naturally jumped to that. He rejected the idea on the basis that it would react with some of my medications and we want my psychosis to remain mostly in control. Upon looking into it, I was looking at the different lines of treatment and Depakote came up. I was wondering how effective this drug is in combating mania/hypomania associated with schizoaffective bipolar, or even bipolar in general. Everyone is different so I'm looking for the good, the bad, and the ugly. Thanks.
  10. I’m currently on trileptal for hypomania, but it has made me really depressed... so i’m looking for another med to control hypomania. already tried lamotrigine and neurontin. thinking next stop will be either depakote or lithium. I’m really afraid of weight gain and of feeling too flat (zombie-like). Which will you recommend? Any experiences you can share?
  11. Okay so I'm on a lot of meds now and just started seeing a new pdoc who's thinking of making some serious changes. I have bipolar, anxiety, ADHD, hypothyroidism, and a pituitary tumor. When I was first diagnosed with BP, I was on lithium and seroquel, which worked well enough until I got depressed enough to get hospitalized a second time. That's when I added klonopin and switched to depakote because lithium was starting to affect my kidneys. This combo controls my mania more than my depression and my anxiety is still bad. My previous pdoc added Strattera for the ADHD but I'm not sure it's actually doing anything. She also added a small dose of trazadone because I was having trouble falling asleep. That helps but also might be making me sleep too much. Anyway, new pdoc suggested replacing the seroquel and/or the depakote due to weight issues and fatty liver (which may be from the depakote or just cause I'm fat who knows). He thinks Saphris could replace Seroquel and be better from a weight perspective. However, I'm dependent on Seroquel for sleep in addition to my other meds, and it doesn't seem like Saphris has that same effect. I'm more open to changing up the Depakote since I gained a lot of weight on it, but I don't know how good the other mood stabilizers are with mania, which has caused big problems in the past. Does anyone know much about Saphris and sleep or weight gain? And what other mood stabilizers might be good (i.e. More weight neutral and helpful for depression and mania).
  12. hi everyone, im looking for advise because im on 500 mg depakote for my mood and migraines but it makes me waaaay to sleepy making it hard to live a normal life i have started taking my pills earlier than usual but it hasnt made a big change, i used to take them at night and now i take them around 5pm, so i wonder, how can i deal with sleepiness? what do you do to wake up?
  13. hi everyone, im looking for advise because im on 500 mg depakote for my mood and migraines but it makes me waaaay to sleepy making it hard to live a normal life i have started taking my pills earlier than usual but it hasnt made a big change, i used to take them at night and now i take them around 5pm, so i wonder, how can i deal with sleepiness? what do you do to wake up?
  14. Sorry to keep going on about side effects, I just want to know. Has anyone had substantial (diffuse, all over perhaps) hair loss from any of the AED's, that upon quitting that medication, eventually that hair loss reversed and it regrew? I know it sounds vain, and hair isn't everything to most people... but can it grow back - its diffuse loss for me right now. I am male, just turned 30. I don't have a recession or if I do its very mild. My hair had loss before, but it was controlled - and was due to Adderall just being on that a couple days actually (as strange as that may sound). BUT being on lamotrigine, years later - my hair no longer looks good, and is straw like and very thin. I had 80% of my hair and it looked amazing, as I started with a thick full head of hair. You could see expanded part lines and such when I had the incident on Adderall. ANd then I switched to Dexedrine eventually and used some Spironolactone cream at nights, to prevent shedding. When off Dexedrine I barely shed. Same with other meds. Dexedrine was less bad than Adderall. So that was my mid to late 20's hair and medication wise. And in the last winter till April, I really tried to "get used" to the side effects of Lamictal, but I couldn't. I liked it and it did make me feel more resilient and grounded and calm and less depressed - but it simply wasn't good for me to have the side effects. They were affecting my self-esteem. I've been off of it since April 22 I think, and I hope hair regrows. I am now on Finasteride - and have been since January, but am taking a small break from that and then restarting it at a micro dose (as they have similar DHT inhibition anyways, and hopefully I can reduce side effects). I didn't even realize that I was losing hair on Lamotrigine, until at least a few weeks later or a month or so. I was more concerned with the death rash, and the other side effects. EDIT: This is really disheartening... I guess it doesn't often reverse with Lamictal? I've read studies showing it's rare.
  15. Ok, so I've had PTSD since 2007 when I was still in the Air Force. My meds just aren't working right to me, and I'm having side effects from one of them. I'm on 1000mg Depakote ER, Cymbalta (I forget how much), and 3mg Risperadone (Risperdal). I was taking 750mg of Depakote and 6mg of Risperadone until recently...we're trying to take me off the Risperadone, so the pdoc is upping the Depakote. I see *a* pdoc in the afternoon (my normal pdoc had to cancel and I wasn't waiting until June to talk to someone...I don't like my experiences with the VA for the most part). Anyway, so the plan is to take me off the Risperadone, but I have a major concern...I'm already getting really, really irritable! I haven't really been getting *more* angry, but I still get really angry more often than I'd like. But the irritability is driving me nuts and feels like it's getting out of control, and I'm afraid it's starting to interfere with my work, and I work in a call center and they record and listen to the calls... I also have issues regarding the Depakote. I kinda need to stay on the Depakote because it supposedly helps with my migraines too (which are getting to the point where I'm getting ready to go back on Botox again), so coming off of it and switching to something different may not be an option...I'd want my pdoc to confer with my neurologist before making that decision so they can both make arrangements and changes if necessary. Anyway, I also have narcolepsy. The last time I was on 1000mg of Depakote I almost drove through a bush in the middle of someone's yard. Granted, I wasn't on the stimulant I'm currently taking back then (Nuvigil). But I have concerns that it could make me drowsy again. But like I can take percocet and benedryl and be wide awake, so who knows...I don't normally take pain meds, just when I get kidney stones, but when I do I have to take benedryl because it makes me itch. I'll let you know what the pdoc says tomorrow, but I'd love some input on ideas I can discuss with the pdoc on my next visit. I need something for irritability, depression, and anger (preferably no more than 2 meds), and if one of them could help with migraines too (like Depakote) that would be great...
  16. Currently on a low dose of 500 mg of Depakote ER (blood level ~43), along with Lamictal and a couple other meds (see sig.) I want to ditch Depakote because the combination of two mood stabilizers is messing with my cognitive function. I have Bipolar type II: infrequent episodes of irritable hypomania, predominantly depressive episodes (previously rapid cycling). I *think* my pdoc and I added Depakote to help with irritability and/or agitation, but naturally I can't remember. I have since stopped cycling now that I'm taking two AED mood stabilizers. But I'm not fully convinced I need both to maintain wellness; I don't think I was on Lamictal long enough to gauge whether or not it could act as monotherapy. I've been reading plenty of articles where Lamictal is effective as a standalone mood stabilizer. I suppose what I'm looking for is insight/input as to whether or not people are able to manage BP2 without Depakote, or perhaps for those that currently take Depakote, why do you take it?
  17. Had to quit lithium due to kidney disease. so pdoc put me on Epilim (Depakote) last Friday, 400mg to start with. The thing is...I'm absolutely obsessed with food and cannot stop going around the kitchen looking for food and thinking about what I would like to eat. I don't really feel more hungry than normal, just want to keep eating. And this is only day 4 on it!! This is crazy! I'm afraid to weigh myself but I will do so tomorrow morning to see the bigger picture......ouch! Anybody else taking this medication want to eat all the time and think about food but not really hungry?? I really have to knock this on the head or I will gain the 20 lbs I have slowly managed to lose....And gain more along with it!!
  18. So l saw my pdoc today and he has decided to discontinue my lithium totally. This is due to the latest blood tests which shows I have grade 3 (out of 5) chronic kidney disease. He started me on Epilim Chrono (sodium valproate) which most people know as depakote. My starting dose is 400mg. I was on this several years ago with a lot of other medications so cannot recall side effects. I know that weight gain can be a problem. My pdoc also said that I may feel sedated on it. Any side effects I should be aware of?? Also, going off lithium is of great concern. I was on it for 13.5 years. I have been tapering off it and I know there is a real risk of me becoming manic. My pdoc will be seeing me more frequently to keep a good check on things and the community psychiatric nurse will be in close contact with me. For anyone who has had to taper off lithium...... Was it a rocky road?? For anyone switching from lithium to valproate..... How did it go? Boy do I HATE change!!!!!
  19. So I've been on lithium and Seroquel since 2011 for bipolar mania. It's worked pretty well, but the lithium has caused hypothyroidism as well as early signs of kidney problems (renal tubular acidosis). Neither of these are bad enough to pull me off the lithium at the moment. Earlier this year, I started sinking into a depression fueled by school and medical issues. Eventually, my pdoc added Prozac for depression and Klonopin for anxiety. To make a long story short, the depression/anxiety were bad enough to get me into a partial hospitalization program (PHP). The PHP pdoc told me that Prozac can cause mixed states and pulled me off of it. In retrospect, this makes sense--I've been happy and energetic one day, angry the next, tired and sad the next, but not enough to be fully manic or depressed (in my mind). He's also increased the Seroquel and Klonopin and that seems to be helping. He also brought up the idea of taking me off lithium in light of the risk of long term health programs (I'm 25 so I'll be on these meds for a long time) and putting me on Depakote. He said since I'm being monitored more closely in the PHP, now would be a good time to do this. He said we could talk about it this week since it's not urgent. I'm a bit attached to Lithium since it kept me stable for so long, but I am concerned about the long term effects, plus clearly something isn't working now if I need to be in a PHP. Maybe this is a risk I need to take. Has anyone here switched from Lithium to Depakote? What are your thoughts on it?
  20. Hi - I currently take a combination of Lamictal (150 mg) and Depakote ER (500 mg) to treat Bipolar II Disorder. The other meds I take (in my sig.) I have been on for years. This recent combination helps me stay stable and has allowed me to feel the best I've ever felt since starting medication in 2009. The problem: when I exercise, it seems my body can't regulate itself; I get extremely overheated and dehydrated, dizzy, lightheaded, nauseas, and shakey. I have been on many psych meds known to cause these issues (Seroquel XR, Zyprexa, stimulants, etc.) and have never experienced this while working out. Does anybody take a combo of Lamaictal and Depakote, or either of these meds by themselves (or even another AED mood stabilizer) and experience these kinds of effects during physical exertion? Its really, really bothersome and interferes with my overall health, but I'm nervous to discontinue either med, as I feel like their synergy has brought me to stable levels and I'm afraid of relapse. My doctor knows about the side effect, and said to drink plenty of water...no such luck. Any ideas or input?
  21. Hi guys, My pdoc is refusing to put me on Depakote because he said there's a high chance I'll develop Stevens-johnson Syndrome. I know this is an issue with Lamictal (which I currently take, but it has pooped out), but I've never really heard of it being a problem with Depakote. When I said "Yeah Lamictal can cause that too," he said it didn't. That doesn't bode well for his competency ... I'm hoping he just brain-farted and got the two mixed! Also, I know Depakote is mainly used to treat mania, but do you think it would help Bipolar II depression? If not, perhaps it will stop my Ultra-Rapid Cycling (weekly), which in theory should stop the cycling into depression. Please let me know your thoughts and experiences. I see him on Friday and am trying to do my research beforehand. Thanks! troop
  22. Hello, I'm 25 and was hospitalized in September 2014 for manic episodes. The doctors put me on 3mg of risperidone (risperdal) and 750mg of depakote daily. After 9 months of taking the medication I really started to see a decline in sexual drive and performance; my libido was essentially taken away. The risperidone/depakote pretty much kills orgasm and gives me erectile issues... I can't maintain an erection. It's like getting your manhood stripped. I feel helpless, I'm at wits end, and I don't know what to do. I talked to my psychiatrist about my erectile dysfunction issues and he decided to lower the risperidone to 1mg and leave the depakote the same. So I've been on 1mg of risperidone for the past month but lowering the medication didn't really do anything. How am I still having this erectile dysfunction problem if I'm only on 1mg of risperidone and 750mg of depakote daily? The bigger question is how am I going to be able to solve this problem that's making me question whether I want to live anymore. My penis was my biggest asset, no pun intended. But now if I don't have that, I feel useless and like nothing, worthless. It's like I'm half a man because I'm only 25 and am already having erectile dysfunction. I don't want to have to start taking any more pills to solve this problem! No viagra, wellbutrin, or any other pill. I ultimately want to get off this medication so I can live my life normally without dependence on any pharmaceutical drug. I'm tired of being a chemical prisoner and just want to live the rest of my 20s like a man should, with a lot of sex. What should I do?
  23. Why would lithium exacerbate o.c. symptoms? There's several small studies, as well as numerous anecdotal accounts, of other mood-stabilizers being helpful with o.c. symptoms. Lamictal and topamax in particular. However, I've read that lithium can exacerbate o.c. symptoms? Does anyone know if it does the opposite of inhibiting glutamate perhaps?
  24. Hi all - Started Depakote about 4 weeks ago. First 2-3 weeks were magical. It calmed my anxiety and dysphoric mood down incredibly. It felt like a magic bullet. The stomach side effects sucked at first, but I adjusted quickly. Fast forward to this week, and I feel incredibly depressed. It came out of nowhere. I had been doing fine on Depakote, Wellbutrin, and Intuniv for almost a month, and then got smacked in the face with depression. True anhedonic, apathetic, tearful, miserable, flat affect depression. I got permission to swap Wellbutrin (which I'd been on for the duration of this Depakote trial) for Lexapro, my old SSRI. Is an SSRI enough to control this? Will I need to hop off Depakote? I've heard its not truly meant for maintenance therapy, but I figured what works in the beginning should surely continue to keep working over a longer span of time. Perhaps I'm wrong. I was so happy to have gotten off Seroquel XR...Depakote definitely controls my agitation better. I just hate that I yet again have to go back to my pdoc with another med failure after telling her things were going so well.
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