Posted by Jonathan on July 25, 2003, at 23:54:54
In reply to Mood stabilizers enough for bp depression?, posted by katia on July 24, 2003, at 15:19:46
> Any good experiences (or bad) out there on Depakote? I start it today.
Hi, Katia.
I've only been taking Depakote for a fortnight - barely long enough to say much more than a supportive "Hey! I'm taking 500 mg twice a day; how much are you on? Aren't the vivid technicolor dreams great!" before we get redirected to PBS for not being sufficiently pharmacological.
To deal first with your principal concerns, I shouldn't expect to notice either weight gain or hair loss so soon even if it were occurring, but I can say that I haven't experienced any increase in my appetite, and my hair growth and the few strands of hair collected on my brush and comb every day seem normal; by the way, my absence of hair loss isn't caused by a lack of hair to lose - if male baldness is virile then I'm not!
I'll let you know of any changes over the next few months that might be due to Depakote (if I can squeeze through the doorway of the spare bedroom in which I keep my computer and if I can find the keyboard under all my moulted hair).
I'm not that worried about either weight gain or hair loss because they are slow in onset and easily reversed after stopping the drug, and there are plenty of alternative mood stabilizers to try if I have to stop Depakote. If, after I've tried all of them, there is really no alternative to my present slim, hairy but depressed state except for fat, bald and happy, then fat, bald and happy will be my choice: unlike depression, neither weight gain nor hair loss, although unwelcome, will cause me to make serious plans to kill myself.
The thing that concerned me most when I started taking Depakote was that it made me feel so drowsy all day and sleep longer every night; I missed a couple of evening doses in the first week because I fell asleep immediately after dinner. This is a worsening of my normal, lethargic depressive symptoms: there is an external reason, however, independent of drug changes, why I might have become even more depressed recently so perhaps it's unfair to pin all the blame on Depakote.
The second week has been much better: the daytime sleepiness has almost gone, though I still need to sleep about an hour more every night. Perhaps the extra sleep is REM sleep, because my dreams have become very much richer, more interesting and professionally scripted. I remember that the benzodiazepine Mogadon (nitrazepam) had a similar effect on my dreaming life when I was a student unable to sleep unaided in the run-up to exams. This is interesting because both Depakote and benzos, by different mechanisms, enhance GABAergic neurotransmission.
This dream enhancement is the only welcome effect so far, but it's too early yet to expect any therapeutic action: I'll let you know in a few weeks whether or not it seems to be beginning to work. On the plus side, the only adverse effect is a little more lethargy and a need for more sleep. Until it starts to work, if it does, Depakote could almost be a huge, shocking-pink, vanilla-flavoured sugar pill. My pdoc warned me that nausea and even vomiting are common side-effects, which can be prevented by always taking the tablets after food, never on an empty stomach: I've always been very careful to do this and it works.
There are a couple of things you perhaps wanted to know about Depakote but were afraid to ask your well-known pdoc: I was afraid to ask mine, who's almost certainly less famous. Because of the obvious similarity between a seizure and an orgasm, I feared that anticonvulsants like Depakote might cause anorgasmia. I now know that this fear was groundless: it has no adverse sexual effects of any kind, at least for a man. A couple of nights ago I was unwise enough to share two bottles of wine, drinking about half of each. This is obviously a very bad idea for anyone suffering from depression; the good news is that I don't think the Depakote made the consequences any worse than before I started it - I just felt even more miserable than usual the next day.
As well as 1000 mg of Depakote in two 500 mg doses, I'm continuing (at the same dose as before) the two meds that I was already taking:
(1) lithium carbonate 1000 mg every night, which I've been taking for six months, and
(2) lofepramine 70 mg three times a day, which I've been taking for a year.
Lofepramine is a tricyclic antidepressant with similar properties to desipramine (which it has superseded here in the UK) - inhibits reuptake of norepinephrine but not serotonin; antagonist at alpha-1 noradrenoceptors and 5-HT2 - it's rapidly metabolized into desipramine itself.I hope that your introduction to Depakote will be as painless as mine was, Katia, and that your simultaneous withdrawal from antidepressants will remain bearable.
Pleasant dreams :)
Jonathan.
poster:Jonathan
thread:244928
URL: http://www.dr-bob.org/babble/20030723/msgs/245383.html