Depakote

How it works

     * Depakote is a brand (trade) name for divalproex sodium. Depakote
       may be used to treat certain types of seizure, to reduce mania in
       people with bipolar disorder, and as a preventive treatment for
       migraines.
     * Experts are not exactly sure how Depakote works although they
       suspect its activity is related to increased brain concentrations
       of gamma-aminobutyric acid (GABA) - a neurotransmitter in the brain
       that calms nervous activity.
     * Depakote belongs to the class of medicines known as antiepileptics
       (AEDs) or anticonvulsants.

Upsides

     * May be used either alone or in combination with other
       antiepileptics for the treatment of complex partial seizures,
       absence seizures, and for several other types of seizure.
     * May be used to control manic episodes in people with bipolar
       disorder.
     * May be effective for the prevention of migraine headaches in some
       people.
     * Depakote is available as a generic under the name divalproex (may
       also be called divalproex sodium).

Downsides

   If you are between the ages of 18 and 60, take no other medication or
   have no other medical conditions, side effects you are more likely to
   experience include:
     * Abdominal pain, nausea, diarrhea, constipation, dizziness,
       drowsiness, weakness, and weight loss are the most commonly
       reported side effects. May also cause bleeding gums, bloating or
       swelling, cough, a tremor, hair loss, ataxia, nystagmus, skin rash
       and thinking difficulties.
     * Side effects such as an increase in liver enzymes and
       thrombocytopenia (a decrease in platelet numbers in the blood) are
       more prevalent at higher dosages.
     * Depakote may not be suitable for everyone including those with
       depression or other mental illness, HIV or cytomegalovirus
       infection, liver disease, mitochondrial disorders, or urea cycle
       disorders. Elderly people may be more sensitive to side effects
       including drowsiness.
     * May cause fatal liver failure; the risk is greatest in children
       aged less than two and people with underlying conditions (such as
       mitochondrial disorders, preexisting liver disease, and a urea
       cycle disorder).
     * Depakote is not recommended for migraine prophylaxis in pregnant
       women. If you are using Depakote to treat epilepsy of manic
       episodes use effective birth control and speak to your doctor
       before choosing to become pregnant. Depakote can cause birth
       defects in unborn children.
     * Cases of life-threatening pancreatitis have been reported in both
       children and adults receiving valproate short-term or long-term;
       symptoms include abdominal pain, nausea, vomiting and weight loss.
     * As with other antiepileptics, Depakote may increase the risk of
       suicidal thoughts or behavior particularly in young adults under
       the age of 24. Monitor for worsening mood.
     * May interact with a number of different medicines including
       aspirin, other antiepileptics, carbapenem antibiotics, felbamate,
       and rifampin.

   Notes: In general, seniors or children, people with certain medical
   conditions (such as liver or kidney problems, heart disease, diabetes,
   seizures) or people who take other medications are more at risk of
   developing a wider range of side effects. For a complete list of all
   side effects, [84]click here.

Bottom Line

   Depakote may be used in the treatment of epilepsy, mania, and to
   prevent migraines; however, people taking Depakote should be monitored
   for potentially fatal side effects such as liver failure and
   pancreatitis and it should not be used in women of childbearing age
   unless benefits outweigh risks and reliable contraception is used.

Tips

     * Swallow Depakote tablets whole, do not crush or chew. Depakote
       sprinkle capsules may be opened and the medicine sprinkled onto a
       spoonful of pudding or applesauce to make swallowing easier.
     * Dosage depends on a number of patient factors including age,
       medical condition for which Depakote is prescribed, sensitivity to
       side effects, the presence of dehydration and nutritional status.
     * Always take Depakote with plenty of water and maintain good
       hydration throughout the day.
     * If you experience stomach upset while taking Depakote, try taking
       with food or ask your doctor if you can titrate your dosage more
       slowly.
     * May cause drowsiness and affect your ability to drive or operate
       machinery. Avoid alcohol
     * Be alert for changes in behavior including agitation, depressed
       mood, and suicide-related events and seek medical advice if changes
       are apparent.
     * Always take Depakote exactly as prescribed. Never take too much
       Depakote or stop suddenly without your doctor's advice. Symptoms of
       overdosage of Depakote include changes in consciousness, fainting,
       and slow or irregular heartbeat.
     * Contact your doctor urgently if you experience stomach pain that
       spreads to your back, nausea and vomiting, dark urine, facial
       swelling, loss of appetite, or yellowing of the skin or eyes. Also
       contact your doctor if you experience any mood changes, unusual
       bruising or bleeding, flu-like symptoms, severe skin reactions, or
       worsening of your symptoms.
     * Blood tests may be needed to monitor effects of Depakote.
     * Always tell your dentist or healthcare provider that you take
       Depakote. Wearing a medical alert tag is a good idea.
     * Avoid excessive sunlight exposure or tanning beds as Depakote may
       make you burn more easily. Wear sunblock and protective clothing
       when outdoors.

Response and Effectiveness

     * The time it takes for Depakote to reach its peak effects depends on
       the formulation used. Tablets take 4 hours to reach a peak,
       Depakote sprinkles take just over three. Food can delay the
       absorption of Depakote (food has a more significant effect on the
       tablets compared with the sprinkles).
     * It may take several weeks of regular dosing before an effect on
       mood or seizure frequency is reported.

References