Depakote

[Echo]

I searched this board and found almost no info and experiences with Epival. I wonder why? Is this drug not prescribed on a regular basis? Hmmm.

I was rx'd Epival (250mg) yesterday along with Seroquel (50mg) both at bed time. My pdoc discussed in depth the possible side effects and ended up telling me that ultimately epival causes weight gain and hair loss in only 5-10% of the population. He also told me that less than 1% of women on epival will develop polycistic ovary syndrome, but that is was more unlikely than just about anything to happen.

Okay, first I will say YIKES.

Second, I was reading up on the Epival today and read some things that completely contradict his information! They say that upwards of 82% of people gain weight on epival and most experience hair loss at first, but it will grow back. Also, 80% of women (especially those under age 20) who are prescribed Epival will develop polycistic ovary syndrome!

I am having children in the near future and absolutely cannot have my fertility affected!

So, what has your experiences been with Epival? Side effects, how long they lasted, if you developed polycistic ovary (if you're a woman, lol) etc. Oh, and if anyone knows, is polycistic ovary syndrome reversable?  Like, if I developed it and stopped the medication would it go away? I know it's the wrong place to ask but I may as well include it anyways incase one of you intelligent folks is knowledgable in that area as well.

I am so freaked out. I can't deal with those odds if my pdoc is indeed incorrect.

What the %$^#?!

Ahhhhhhhhhhhhhhhhhhhhh.

Any information will be greatly appreciated. I'm freakin' out here.

[Sulu]

Echo, sometimes the drugs for mental illness seem worse than the disease.  I am taking Epival which is called Depakote in the U.S. I believe.  I am also on Seroquel.  I have gained a lot of weight and asked my pdoc which one might me causing weight gain.  She said Seroquel so I lowered my dose from 50 mg to 25 mg as I am basically using it for insomnia and 25 mg seem to be enough for that.  I take 500 mg of Epival at bedtime.  I think my pdoc might have blamed weight gain on Seroquel because she wants me to stick with the Epival.  Lithium was not good for me and I have itchy skin all the time so I have not asked for Lamictal because I also have a very overactive imagination.  Someone says bug and I get itchy right away. LOL.  I really don't have much info for you and you haven't said in your post  what you are being treated for and what other drugs you are/have been on.  Did you voice your concern with your pdoc about taking Epival and the effect it might have on having children?  Hang in there and let us know what is happening.  Sulu

[Echo]

Echo, sometimes the drugs for mental illness seem worse than the disease.

[Sulu]

How long have you been on the epival for?

Have you had any problems with your period? (heavier, irregular, pains, etc.)

Have you noticed any hair loss?

How much weight gain?

Skin problems (acne, darkening of the skin on the face and neck, etc.?)

I have been taking epival since last October I believe.  I am currently not having a period (since January) but I am 52 and due for menopause so who knows why.

My hair has thinned a fair bit, but again, menopausal symptom?

I was about 120 pounds before meds and am somewhere around 155-160 now.

My skin is very dry as well, menopause?

It is so difficult for me to know which is meds and which is menopause because my symptoms could be due to both.  Sorry I am not much help but hang in there as there are a lot of folks here who are bound to know more.  Stay well, Sulu

[Echo]

How long have you been on the epival for?

Have you had any problems with your period? (heavier, irregular, pains, etc.)

Have you noticed any hair loss?

How much weight gain?

Skin problems (acne, darkening of the skin on the face and neck, etc.?)

I have been taking epival since last October I believe.

[Echo]

If possible could a mod change the name of this thread from "Epival" to "Depakote"? I think it would yield more replies as Epival is the Canadian name for Depakote and a lot of people might not know that.

I need all the help I can get!

Thanks,

Echo

[NARS]

I have PCOS and recently went off Depakote.  I was willing to deal with the weight gain, but not insulin and wacky hormone problems.  But I was very stable on Depakote for 5 years, so it did its job.  It's one of the old standards, well known in its effectiveness, and it may be exactly what you need.

My internet reading said that somewhere from 10-20% of women on Depakote develop PCOS while on it.  In my case, my nurse said that my symptoms say I've had PCOS since puberty and that the Depakote made it worse.  At any rate, the studies suggest that women should watch for symptoms for the first 3-6 months of taking Depakote.  Symptoms include menstrual irregularities & insulin-related stuff like blood sugar swings, weight gain, etc.  You should get fasting insulin and glucose levels and measure them not by diabetic standards but by PCOS standards (anything over a value of 10 in fasting insulin indicates PCOS).  Any elevation in testosterone is also an indicator.

At any rate, your pdoc is extraordinary for telling you about this side effect.  Tell him you're worried about it, and that you want to be tested frequently for insulin levels. 

[Echo]

I have PCOS and recently went off Depakote.

[scarlet_faery]

Echo,

I would also have your liver levels checked too.  Mine went sky high in 72 hours!  Almost toxic.  As for the Polycystic Ovarian thing...must be nice that your doctor told you about it in the first place.  I have the disease and was never told that Depakote could or would have an effect on it.  That just makes me even more angry with the bitch doctor who put me on it when I went to the hospital.  She had my chart with my entire health history, and she overlooked that??  Ignorance.  I don't care if these doctors only have a few minutes to glance down at patients charts, they should look and see what diseases people have so they don't risk their health.  Now my liver is all screwed up because of her.  *sighs*  And you know something, I had her husband as my regular Pdoc. 

God help me when my kidneys start to go and I go on dialysis and need a transplant.  I think I'd rather die than to have my life put in some doctor's hands anymore.  I just don't trust doctors. 

Elizabeth

[Echo]

Echo,

I would also have your liver levels checked too.

[NARS]

I gained about 30-40 pounds over 5 years, which is considerable, as I'm 5'2".  My hair seemed to thin over the temples, but more annoying was the increasing hair on my chin and face.  Not as severe as many have, but still a bit annoying.  As I said, I've had PCOS forever, so the Depakote only made it worse.  I can't entirely blame my pdoc; it's only been in the past few years that anyone did studies with these findings.  Before that they just thought we were just being lazy

You should also know that thinning hair and weight gain are potential side effects of lots of mood drugs, it's just that some are worse than others.  Also remember that not everyone gets the side effect, even with the most "risky" meds.  Depakote is right up there with Zyprexa in not only causing weight gain but increasing risk for insulin resistance.  You can find the references if you Google "PCOS" and "bipolar".  The PCOS association runs a website (pcosupport.org) with lots of info & links on PCOS in general.  Dr. Phelps has info on depakote & PCOS on his site (psycheducation.org).

Your doctor should be testing liver function regularly anyways.  Mine did initial tests, then re-did them every 3 months at first, then every 6 months.

[Echo]

Nars -

Thanks for the valuable info. I am going to ensure that I am tested regularly not only for the regular stuff but also for the insulin, etc.

I really hope I don't develop facial hair.  Gosh. How early did you begin to see this s/e? what about the thinning of your hair at the temples? weight gain?

I've been on the meds for 3 days now and all I have noticed is my incredible exhaustion. The only time I seem to have energy at all is right before bed (once the pills have probably almost worn off in my system) before I take the new set for the night. I have also experienced a sort of odd floaty, zoney, zombie-ish thing and I have felt VERY depressed for about 2 days.

*Still scared*, gonna call pdoc today to report these things.

[NARS]

Hey, Echo, try to hang in there if you can.  Are you on an AD?  My pdoc cranked up the Wellbutrin to 200 a day (and I ended up at 300 eventually) which helped with the exhaustion and depressive tendencies.  Depakote actually has a mild AD effect, once you've gotten over the initial wonkiness.  In the meantime, Wellbutrin is a great adjunct AD for BP, and there are plenty of others.  Anyways, the exhausted, floaty, zombie thing will go away over the next few weeks if you stay on it.  I was extremely stupid, too, for the first month or so, then progressively my brain seemed to adjust to it.

When are you taking your depakote?  My pdoc had me take about 1/3 in the AM and the rest at night, since it is such a downer, especially at first.  You do need some in the daytime; it's not as long-acting as some meds, unless you're on the extended release.  Aha!  I just remembered there's an ER form of depakote.  If your insurance covers it, clamor for it from your pdoc!  It's said to be slightly better for wonkiness, and also for weight gain (anectodal, no studies yet).

As for facial hair, I've always had some, it just got worse by about 30% after I started with depakote.  Weight: always struggled mightily with it, but completely lost the ability to lose weight once I started taking depakote, even with extreme dieting.  The 40 pounds creeped up on me over 3-4  years.  Head hair: not sure when that started, and it hasn't ever gotten bad.  Remember I've had PCOS for 35 years, so one way of looking at it is that depakote simply turned my "simmer" up to a boil.

[Echo]

Hey, Echo, try to hang in there if you can.

[Guest Amanda]

I wish I had known about PCOS myself. How come my insulin isn't being checked? I'm on 1000mg of Epival a day...enough that it causes tremors in me...so shouldn't I be monitored more closesly *rolls eyes*

I've been on the med since January I believe. I have gained about 15lbs. It is possible to lose though. (I had been able to lose 10lbs before, gained a whole bunch more (but that was binge eating) and now have lost 5-8lbs again).

My hair is not falling out.

The weight gain and hair falling out my doc said not to worry about, that it only happens on the higher dosages.

I was at 1500mg once and ended up with vision problems and light sensitivity, which literally went away as the med worked itself out of my system. In 8 hrs I could see a bit clearer again and the next day I went back down to 1250 and then 750 and it went away completely.

[NARS]

Amanda, if it makes you feel better, the tremors should go away.  Mine did after a month or two.  In the meantime I learned not to hold out anything in front of me in a meeting lest anyone thought I had the shakes...

Remember the direct connection with insulin is a recent discovery, and even my pdoc, who keeps up with stuff, didn't know until I showed him the research.  Ask for tests, but make sure they don't compare you with type II diabetics; the cutoff for PCOS is much, much lower.  Check out pcosupport.org for more info.  The fact that you can still lose weight is encouraging; that means you probably have gained mostly from being slowed down initially by the med, and are recovered from that now.  My memory is that from the moment I started taking depakote I couldn't lose weight no matter what.