Home from the Hospital, started Depakote, I think my Dr. wants me dead.

[D3N0]

I'm just kidding of course about the Dr. thing. But I am home from fabulous 6 day, 5 night all inclusive stay at the psych floor of the local hospital, 'oooh--ahhhh' (does it just about kill anyone else to think about the 'real' vacation you could have with the co-pays these hospital stays cost?? OY!). I got started on Depakote and it's terrible.

Anyways, I went in on the recommendation of my Dr. on the outside. I have been on and off about every dang drug for the last year and a half or so and I think she pretty much threw her hands up in exasperation.

I went in, they discontinued everything I've been taking but the Lithium, also added Depakote at 1500mgs. I got siiiick. I don't think, now after reading, that you are really supposed to jump in to depakote at that kind of hit dosage! (of course in the psych ward not like you can access the outside world and find any of this out :\ ).

They gave me one full day of 1500mgs straight off the bat. And then my ammonia levels went sky high (I guess, I don't know anything about it, kinda why I'm here). The 2nd day or so my ammonia was '93'. Then they backed the dosage off to 1000mg and it went down to '84'. Finally on Monday it was down to '32'....which was apparently acceptable and I was allowed to come home (I have 3 kids ages 12, 10, 8 and was adamant to be home for their first day of school).

Anyways, mostly I'm looking for information on those ammonia levels. I've not found much about them except for with people with cirrhosis of the liver etc, not much directly correlating to depakote usage/dosage. I do know I felt very 'groggy' and still feel quite groggy on the Depakote. I think the only way it works to alleviate manic episodes is bc you still come up with the ideas, but no way you can get the gumption together to act on them LOL.

So does anyone have experience with Depakote and their ammonia levels? TIA

[gizmo]

you really should start depakote off at 500 mg a day, and increase it about once every 5 days by another 500 mg until you reach your target dose.

I take 2000 mg a day, and I can't imagine how awful I would feel if I started off that high. It would be BAD.

Call your pdoc and tell them you want to titrate up slower because of your extreme side effects. Get their ok.

PS: This quick search gave me lots of options about depakote and ammonia, but I didn't have time to read any. https://www.google.com/webhp?hl=en&tab=ww#hl=en&sugexp=les%3Beqn%2Cfixedpos%3Dfalse%2Cboost_normal%3D40%2Cboost_high%3D40%2Ccconf%3D1.0%2Cmin_length%3D2%2Crate_low%3D0.030%2Crate_high%3D0.030%2Csecond_pass%3Dfalse%2Cignore_bad_origquery%3Dtrue&gs_nf=1&gs_mss=ammonia%20levels%20d&tok=QXrBny9G56sr8Tt0h398IQ&cp=18&gs_id=jy&xhr=t&q=ammonia+levels+depakote&pf=p&sclient=psy-ab&oq=ammonia+levels+dep&gs_l=&pbx=1&bav=on.2,or.r_gc.r_pw.r_cp.r_qf.&fp=c7a7e6ff1929af1c&biw=1440&bih=807

[paellamagi]

I can't believe they put you on such a high dose straight away. I'm on a similar med and they had me titrate up very slowly to try and hit a therapeutic range (mind you this was on the outside).

[Squirlygrl]

Welcome back and congratulations on making it through the first day of school. I know how much that means to your kids, and how hard it must have been to do it in a fog.

I take 3250 myself and probably left the hospital around 2000. They hit me with it quickly, but they were desperate. Extended release can make you a lot less sick. I think anything makes you groggy at first, but that wears off. I do not feel that way now. I also feel like I could never be manic again, ever. True, the dose did creep up, but that is because I had some intermittent residual psychosis and APs were a bad fit.

Try ginger, small meals, crackers while you are settling in. Stay far, far away from Pepto-Bismol; it has a nasty feedback loop that will make you sicker. I do have food aversions and cravings that I didn't before. All of that said, this stuff is the bomb -- and it just did not work for me at 750 mg.

Sorry that I have nothing specific on ammonia; I know that is what you asked. Your regular doc should be giving you a lot of blood work to start anyway.

[bpladybug]

Well I am a little shocked that they started you so high. I took it for a number of years.

I did not like it, and I had a number of bad side effects, which I won't share here unless

you request it.

I greatly prefer Lithium plus an AAP. GREATLY prefer that to Depakote.

But everyone is different. It can be helpful for people with bad mixed episodes.

I know some people LIKE it.....but not me.

My dose was 2500.

[Mirazh]

I do 750mg/day. Some mild side effects when I first went on. Started at 500mg/day and other than SEs did not feel like I was taking anything, but after being bumped up to 750mg the depression I was mired in, lifted.

I am also surprised they started you so high, but IP is sometimes used for fast changes like that, still makes me ???

You should be getting regular bloodwork, liver function, valproate levels, etc. My gdoc is lovely but also very busy and I had to take the initiative to book my appointments to get the lab requisitions. But they've been good for enough times that my pdoc says I can reduce the frequency to one every six months now.

[Ems1981]

I don't have expierence with mood stabilizers, yet.

But congrats on being back home. Wishing you the best of luck and I'd definitely keep tabls on all of your side effects/concerns for your dr. Will you be seeing the same Dr. outside that you saw in the hosp?