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I have been rapid cycling (predominantly mixed or depressed) for four months.  Depakote is the only mood stabilizer I have not tried.

Has Depakote, at any dosage, been helpful to anyone?

I'm afraid of PCOS, weight gain, and cognitive side effects.  But I am also in such a severe state of crisis that I know I need help *now.*

Any experiences or thoughts are welcome.

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Worked better for me second time around on a short term treatment.

Felt stability on third day on a high dosage, on the fourth day I was already feeling pretty under control.

After reaching the blood serum dropped the dosage and sustained the stability with something else for personal choices of more 'superficial' side effects.

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The one experience I had with depakote was that is made me VERY tired/groggy/sleepy.  If you decide to try it, I would make sure you are home the first couple days.  I came off of it rather quickly (although I really don't remember that much because of the sleepy etc side effects) because I didn't find it helpful and the tiredness etc never wore off.

I'm not saying it was a bad med, just saying that was what I experienced.

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Depakote is considered by some to be the first line treatment for rapid cycling and mixed states, certainly it has been successful treating rapid cycling and mixed states in some people. Have you tried lithium, divalproex, lamotrigine, carbamazepine, and atypical antipsychotics alone or in combination ? I have read of one method of dealing with depakote side effects. Reduce the depakote and add a small amount of lithium.

 

http://bipolarworld.net/Phelps/ph_2004/ph1108.htm

http://www.ncbi.nlm.nih.gov/pubmed/17029493

 

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Thank you for the replies.

@notloki  Some of my med trials were limited due to side effects, which now don't seem so bad compared to this mixed state!  I appreciate the info about combining with lithium.

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It worked really well for me and stabilised my mood. However i developed PCOS and had to quit taking it.

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I fucking love it.  I hope I never have to stop taking it.

I find it a brilliant antidepressant.  Doesn't do anything for me in the physical energy range, maybe even makes me a bit more lethargic even at the super super low dose I am on, but I have other medications to help me with that.  It just evaporates my depression like magic.  And quick.

Cognitive side effects for me are kinda vague brainfoggy for maybe the first... month or so, but then it clears right up.  However, I also take Dexedrine, and I'm pretty certain that helps.  But there is a clearing up of the cognitive side effects on their own, because I recently had to taper back on to my Depakote (it was horrible) and that definitely happened before the attempt to reintroduce Dexedrine was made.

It's possible that slight weight gain and stuff that's indicative of me on my way to PCOS is happening.  Hopefully they'll get the damn inner plumbing out of me (gonna start moving on my medical transition this year, finally) long before that happens, though.

I'm on 1000mg/day, taken in doses of 500mg twelve hours apart.  I get my bloodwork every six months, and sometimes I still get my gdoc's office staff calling me in gentle concern about my valproate blood level almost bottoming out of "effective dose range".  But that's exactly where it's supposed to be.

I am, obviously, bit more of an unusual case with it, though I've met others (on CB!) who respond to Depakote like I do, although I think they're all on more of it than I am.  I was really worried about side effects too, when it was first suggested, but my depression/mixed features are always horrible, and yeah.

Most of my side effects were mild and of the sort that go away after the first month or so.  Like mild heartburn if I didn't take my dose with food.

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I also really like it, smooths out the mood swings,also great for mixed states. I take extended release 1000mg/day. I suggest start low and go up, because if the dose will be too high then Depakote can cause depression (from my experience)

Edited by centaurus

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I have been on Depakote to treat partial seizures for last 12 months.  I was unable to get into the therapeutic range due to my sensitivity to this drug.  I remained at 250 mgs for most of the 12 months I was on this drug.  Then, even though my serum blood tests were stable, I developed Non Alcoholic Fatty Liver Disease and also high levels of Ammonia.  I stumbled upon these two things accidentally and last month after reading the educational material from my pharmacy I contacted the prescribing physician immediately.  I asked to be taken off of Depakote and put on another medication a friend recommended, which is a newer drug mostly for migraines and partial seizures.  I found it interesting that my prescribing neurologist did not put these two together, as I had to call it to his attention.

My neurologist passed me off on another neurologist who is newer and more up to date on seizures for medication management, or so he says.  First appointment is in November.  So, started titrating down from Depakote myself. I think I came down to fast.  I am now taking nothing and thinking what I am experiencing might be symptomatic of withdrawals.  In any event, my mood has worsened, more depressed and migraines have gotten worse.  I am going to have to come off of Depakote eventually. 

The part about Depakote I did not like is that I gained an enormous amount of weight and am now considered obese, it also took hours after waking in the morning before the sedation wore off, by evening I was wide awake. Now that I am off of Depakote I can tell the difference as I don't sleep 14 hours a day and when I wake up, I feel like doing things first thing in the am.   The sedation was the worst part along with the weight gain.  I don't think it really handled the partial seizures as I continued to have hallucinations which is an aura of either the seizure or migraine.

I know if I call my neurologist back he will try to talk me into restarting the Depakote until I see the new neurologist to have seizure coverage.  Thinking I will go back on 125 mg every other day until I see my new neurologist.  Still, it will throw me back into feeling sedated all the time and I can't think straight, much less talk well too.  A friend recommended Zonegran, but my HMO does not have this in their pharmacy.... figures

Just tossing all this out here. 

Purple

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1 hour ago, PurplePaisley said:

I have been on Depakote to treat partial seizures for last 12 months.  I was unable to get into the therapeutic range due to my sensitivity to this drug.  I remained at 250 mgs for most of the 12 months I was on this drug.  Then, even though my serum blood tests were stable, I developed Non Alcoholic Fatty Liver Disease and also high levels of Ammonia.  I stumbled upon these two things accidentally and last month after reading the educational material from my pharmacy I contacted the prescribing physician immediately.  I asked to be taken off of Depakote and put on another medication a friend recommended, which is a newer drug mostly for migraines and partial seizures.  I found it interesting that my prescribing neurologist did not put these two together, as I had to call it to his attention.

My neurologist passed me off on another neurologist who is newer and more up to date on seizures for medication management, or so he says.  First appointment is in November.  So, started titrating down from Depakote myself. I think I came down to fast.  I am now taking nothing and thinking what I am experiencing might be symptomatic of withdrawals.  In any event, my mood has worsened, more depressed and migraines have gotten worse.  I am going to have to come off of Depakote eventually. 

The part about Depakote I did not like is that I gained an enormous amount of weight and am now considered obese, it also took hours after waking in the morning before the sedation wore off, by evening I was wide awake. Now that I am off of Depakote I can tell the difference as I don't sleep 14 hours a day and when I wake up, I feel like doing things first thing in the am.   The sedation was the worst part along with the weight gain.  I don't think it really handled the partial seizures as I continued to have hallucinations which is an aura of either the seizure or migraine.

I know if I call my neurologist back he will try to talk me into restarting the Depakote until I see the new neurologist to have seizure coverage.  Thinking I will go back on 125 mg every other day until I see my new neurologist.  Still, it will throw me back into feeling sedated all the time and I can't think straight, much less talk well too.  A friend recommended Zonegran, but my HMO does not have this in their pharmacy.... figures

Just tossing all this out here. 

Purple

I don't think you should be weaning down without DR supervision.  Maybe with the depakote though, keep on a low dose so you don't go into complete withdrawal?  I'd at least call neuro and ask about that.  It would really suck if you had a seizure because you went off of the depakote too fast, without being put on another med in place of it.

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I wish I didn't have to go off of Depakote.  It managed my moods very well and I never had any bothersome side effects other than weight gain.  I am still titrating down, at my psych docs recommendation, and will then be put on Vimpat.  Vimpat has no mood stabilizing properties, just for seizures. I'm soo tired of medications......... I'm 66 years old and it gets tiring going off of and adjusting to new meds. Then very soon I will be off of all mood stabilizing medications and am somewhat worried about that.  I do have the option of going back on Zyprexa should I need it.

I have to say going off of sedating medications has made me realize just how much I have missed out in life living numb.  Now that I am almost off of Depakote I am experiencing the full spectrum of emotions and feelings, sensations and memories.  Where it is a great feeling now, I wonder if I will be able to cope as memories are now flooding back.

Thank you for listening :)

Purple

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Thanks for sharing your experience, Purple.  My pdoc really wants me to try Depakote, but the side effects still really scare me (especially the weight gain).

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Be sure you randomly check ammonia levels in your blood and also possibly have a baseline ultrasound of your liver.  Even though my liver values remained stable, I developed Non-Alcoholic Fatty Liver Disease and because my liver does not adequately clear UREA, it now passes ammonia into my blood stream which can be dangerous. I am taking Lactalose to help bind the ammonia from my blood to pass it out of my system. If in 4 months I do not see any difference in my next ammonia test, I will ask for more medication to treat the ammonia.  Because these are the two well known side effects, other than weight gain, encourage your primary to check for this.  I had to fight for these two tests to be conducted.  Learned all about this when I worked for my veterinarian.  One of the first symptoms of high ammonia is body wide itching, fortunately the Lactalose is doing it's job.

Hoping you much success with Depakote :)

Purple

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