Jump to content
CrazyBoards.org

Sign in to follow this  
Paperskyscrapers

Thinking of Asking for Divalproex... thoughts?

Recommended Posts

So I am on 200mg clozapine, 200mg lamictal, and 15mg abilify.

But, I'm rapid cycling like hell! I read that divalproex is better for this than lithium.

I'm thinking about suggesting it to my psychiatrist.

I have hypomanic, mixed, and depressive episodes. I was diagnosed schizoaffective, bipolar type.

 

What were your experiences on it? Any tips/points to remember?

TIA!

Share this post


Link to post
Share on other sites
44 minutes ago, Paperskyscrapers said:

So I am on 200mg clozapine, 200mg lamictal, and 15mg abilify.

But, I'm rapid cycling like hell! I read that divalproex is better for this than lithium.

I'm thinking about suggesting it to my psychiatrist.

I have hypomanic, mixed, and depressive episodes. I was diagnosed schizoaffective, bipolar type.

 

What were your experiences on it? Any tips/points to remember?

TIA!

Could you bump your cloz (or maybe even abilify) first? Depakote can definetly help cycling but cloz is pretty good as well....for me it was better all around especially for depression, but Depakote had less side effects.... Depakote didn’t do enough for me on the depressive side to be a stand alone stabilizer...but it seems like you already have good all around coverage so asking about it is reasonable...just a note that Depakote and lamictal can interact and require dose modifications 

Share this post


Link to post
Share on other sites
14 minutes ago, Paperskyscrapers said:

You mean you had less side effects from Depakote as opposed to cloz?

I would need to raise  my lamictal right?

Actually I think you 1/2 lamictal dose. Some Other anti epileptics require doubling. 

And for treating mixed/depression I had way better luck with cloz but couldn’t tolerate a high enough dose to handle all the symptoms, which you may be able to address with the abilify   

Share this post


Link to post
Share on other sites

I was on 350mg cloz, but couldn't handle all the sedation. So my pdoc raised by abilify from 10mg to 15mg. 

I don't think I can go any higher for my clozapine. I just get too sedated.

That's why I was thinking of asking for depakote.

What was the weight gain like, if you had any?

Share this post


Link to post
Share on other sites
12 minutes ago, Paperskyscrapers said:

I was on 350mg cloz, but couldn't handle all the sedation. So my pdoc raised by abilify from 10mg to 15mg. 

I don't think I can go any higher for my clozapine. I just get too sedated.

That's why I was thinking of asking for depakote.

What was the weight gain like, if you had any?

Minor compared to cloz

given- I never took them together 

Edited by Iceberg

Share this post


Link to post
Share on other sites
4 minutes ago, Iceberg said:

Minor compared to cloz

I didn't gain a single pound on cloz, actually. My weight stayed stabled and I was on it since 2017.

I hope the depakote won't make me gain weight either. Just crossing my fingers.

It's so hard to lose weight on these meds and I've been trying really hard.

Share this post


Link to post
Share on other sites
Just now, Paperskyscrapers said:

I didn't gain a single pound on cloz, actually. My weight stayed stabled and I was on it since 2017.

I hope the depakote won't make me gain weight either. Just crossing my fingers.

It's so hard to lose weight on these meds and I've been trying really hard.

Couldn’t agree more. I got really screwed because I had nasty treatment resistant dysphoric mania starting in my early teens...so I fended off the weight for awhile but when I hit 18 ish and my metabolism slowed Down things totally changed and I gained like 30 lbs on zyprexa in like a summer...and it doesn’t look like I’ll be getting off anytime soon. I keep trying to start addressing the weight, but either it is so slow that I lose hope or an episode starts and my ego is too depleted to make progress 

Share this post


Link to post
Share on other sites
4 minutes ago, Iceberg said:

Couldn’t agree more. I got really screwed because I had nasty treatment resistant dysphoric mania starting in my early teens...so I fended off the weight for awhile but when I hit 18 ish and my metabolism slowed Down things totally changed and I gained like 30 lbs on zyprexa in like a summer...and it doesn’t look like I’ll be getting off anytime soon. I keep trying to start addressing the weight, but either it is so slow that I lose hope or an episode starts and my ego is too depleted to make progress 

I get you. I haven't been eating carbs at all and the scale won't budge. I just keep thinking that at least i won't be adding more weight. I was ALWAYS 109 lbs before and I've ballooned to 133 now in 4 years.

Share this post


Link to post
Share on other sites

The cruel irony is that my meds often make me sick when doing strenuous exercise, so even that road is often blocked 

Share this post


Link to post
Share on other sites
7 minutes ago, Iceberg said:

The cruel irony is that my meds often make me sick when doing strenuous exercise, so even that road is often blocked 

Not to mention less motivated due to sedation. 

What was your dose of depakote? and how is it different from valproic acid?

Share this post


Link to post
Share on other sites

Its divalproex- basically the same. 

My doc, as do many, use a blood level to measure the dose for valproate. Typically the therapeutic dose starts at 50 to 85 (forget the units) and goes up to 100ish depending on severity. Some docs will push it to 125- but that can be unpleasant and bring side effects. My doc actually went above that (he was an idiot and panicked cuz he was out of ideas) and the inpatient staff tapered me off about a week later. Obviously those levels are individual and case to case, but I started at 250x3 delayed release and ended up on 2.5 or 3000 extended release. I was also in the hospital when they started it (for mania) so idk what the typical titration is cuz they were going up as fast as possible for me 

Share this post


Link to post
Share on other sites

I tried depakote before, but I gained weight and had bad skin. I was wondering if there's any chance that this time it might be different.

That first trial was 8 years ago.

Share this post


Link to post
Share on other sites
11 hours ago, argh said:

oh. 

Well, I was thinking actually of topiramate instead due to these issues, and also for weight loss.

Do you think that's a good move?

Share this post


Link to post
Share on other sites
38 minutes ago, Paperskyscrapers said:

oh. 

Well, I was thinking actually of topiramate instead due to these issues, and also for weight loss.

Do you think that's a good move?

it can definitely work for weightloss, though i haven't personally used it. I think a few other members here have used it with some success.

however, it has not proven itself to be a mood stabilizer. you might want to consider that as an add on only and not to peel back any of your other meds.

Carbamazepine and to a lesser extend oxcarbazepine are said to deal with rapid cycling as well. Weight neutral if that's also a concern.

 

Edited by argh

Share this post


Link to post
Share on other sites
26 minutes ago, argh said:

it can definitely work for weightloss, though i haven't personally used it. I think a few other members here have used it with some success.

however, it has not proven itself to be a mood stabilizer. you might want to consider that as an add on only and not to peel back any of your other meds.

Carbamazepine and to a lesser extend oxcarbazepine are said to deal with rapid cycling as well. Weight neutral if that's also a concern.

 

Been zig-zagging across Google Scholar to answer my own question. Due to the weight loss effect of topiramate, I might go for it first. But I will wait for what my psychiatrist will say. If he decides to go down the valproate route, then there I go.

Share this post


Link to post
Share on other sites

Depakote was gooood for my agitation but it never was fully able to control my rapid cycling, though it did tone it down a bit. My blood level was as high as 100 µg/mL on 1,000 mg of the ER form. I chose to come off due to side effects that I didn't feel were tolerable for me personally, but all in all I really do like Depakote.

FWIW, starting lithium has stopped my cycling and really controls my mixed depression. I know valproate is touted to preform better in that regard, but if the opportunity for lithium ever presents itself, I'd recommend not immediately writing it off as ineffective. Its the only medication that has ever stabilized me from top to bottom. I started it while I was inpatient.

Share this post


Link to post
Share on other sites
5 hours ago, mjs190 said:

Depakote was gooood for my agitation but it never was fully able to control my rapid cycling, though it did tone it down a bit. My blood level was as high as 100 µg/mL on 1,000 mg of the ER form. I chose to come off due to side effects that I didn't feel were tolerable for me personally, but all in all I really do like Depakote.

FWIW, starting lithium has stopped my cycling and really controls my mixed depression. I know valproate is touted to preform better in that regard, but if the opportunity for lithium ever presents itself, I'd recommend not immediately writing it off as ineffective. Its the only medication that has ever stabilized me from top to bottom. I started it while I was inpatient.

I was on lithium for 4 years, with limited success due to my rapid cycling.

This is why I'm going on depakote for now.

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Sign in to follow this  

×
×
  • Create New...