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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by mr.scott on January 18, 2002, at 13:06:14
Hi There,
Is Depakote a difficult to handle med, causing multiple disturbing side effects, and only to be taken by people with SERIOUS bipolar disorder (the kind you read about in psychology 101 textbooks)?Or is it really not so bad after all.
Just want to know in case I finally decide to give it a try.
Scott
Posted by anniebananie on January 18, 2002, at 13:39:57
In reply to Depakote...An ugly Beast or gentle friend?, posted by mr.scott on January 18, 2002, at 13:06:14
Maybe an ugly friend, one that puts 20 lbs or so on you via serious carbo cravings. Other than that minimal side fx (relatively mild cognitive stuff -- a bit of word-finding trouble), but you do have to have blood tests (not very often) just because it can cause liver damage which also means you can't drink much on it. As my doctor reminded me,"you need your liver".
As for SERIOUS bipolar...I'm not going to touch that with a ten foot pole.
Take care,
Annie
> Hi There,
> Is Depakote a difficult to handle med, causing multiple disturbing side effects, and only to be taken by people with SERIOUS bipolar disorder (the kind you read about in psychology 101 textbooks)?
>
> Or is it really not so bad after all.
>
> Just want to know in case I finally decide to give it a try.
> Scott
Posted by Krazy Kat on January 18, 2002, at 13:54:48
In reply to Depakote...An ugly Beast or gentle friend?, posted by mr.scott on January 18, 2002, at 13:06:14
Mr. Scott:
Here's my experience with mood stabilizers:
Topamax - Dopamax to the hilt and sedation
Lamictal - Makes me feel like I have the flu
Zyprexa - Caused an eye twitch (my pdoc does not agree with this) and weight gain. I stopped it too soon to know if it could help, and am going to try it again, actually.
Depakote - Got me out of two of my worse agitated depressions. Caused weight gain. I have not had any cognitive side effects from it. The lab tests are necessary, and I'm not good about keeping up with such things. It works almost immediately for me.
I know what you mean re: "serious" bipolar disorder - there are degrees of BP. I would say this is a "top gun" - Dr.'s seem more likely to try the ones I mentioned above first. But, to be honest, I had more side effects with the others.
- KK
Posted by susan C on January 18, 2002, at 15:17:13
In reply to Depakote...An ugly Beast or gentle friend?, posted by mr.scott on January 18, 2002, at 13:06:14
My experiences have been like Dr KK. Though I have not gained weight on Depakote (lost some, probably, for other reasons) and I always get my labs done.
Lab Director Mouse eyeing vanilla smelling pink pills
Posted by tina on January 18, 2002, at 16:14:29
In reply to Depakote...An ugly Beast or gentle friend?, posted by mr.scott on January 18, 2002, at 13:06:14
Hey Scott
I started depakote about 10 days ago. 250 mgs a day. I can't tell I'm taking it other than a tiny amount of tummy troubles, not even nausea, just discomfort.
I don't know if it's a friend yet but i'll let you know.tina
Posted by Krazy Kat on January 18, 2002, at 16:19:53
In reply to Re: Depakote...Barely there » mr.scott, posted by tina on January 18, 2002, at 16:14:29
tina:
my understanding is that that is a very low dose.
this is the only med I have tried that worked immediately and almost side effect free at 1000 mg. I would guess from my research that at least 500 mg is needed for an effect. I do have hand tremors on Dep.
I hope it helps you - despite the tremors, it has been the best med yet for me.
- KK
Posted by ST on January 18, 2002, at 17:34:58
In reply to Depakote...An ugly Beast or gentle friend?, posted by mr.scott on January 18, 2002, at 13:06:14
Hi,
Depakote has worked pretty well for me as far as stabilizing moods...I guess...I haven't been hypo manic or manic on it in the past seven or so years I've used it. But it sure doesn't help with depresson. No weight gain. At higher doses it made me lethargic and dead-to-the-world. Not creative, not quick...So I'm only on 750 mg and that seems to work.
I'm a bi polar 2 and according to my doctor "high functioning", whatever that means. So I wouldn't call myself a "serious" bi polar. I don't know. My sister and nephew are also on Depakote (at much higher doses than I) and they are both bi polar 1s. Now they are very "serious", very "textbook". I always assumed lithium was for more extreme bi polars....?
Sarah
> Hi There,
> Is Depakote a difficult to handle med, causing multiple disturbing side effects, and only to be taken by people with SERIOUS bipolar disorder (the kind you read about in psychology 101 textbooks)?
>
> Or is it really not so bad after all.
>
> Just want to know in case I finally decide to give it a try.
> Scott
Posted by ST on January 18, 2002, at 17:37:06
In reply to Depakote...An ugly Beast or gentle friend?, posted by mr.scott on January 18, 2002, at 13:06:14
One more thing...I was on the generic form of Depakote, called Depakene, for quite some time. That caused me MAJOR gastrointestinal distress which I've heard is common. Avoid it if you can.
> Hi There,
> Is Depakote a difficult to handle med, causing multiple disturbing side effects, and only to be taken by people with SERIOUS bipolar disorder (the kind you read about in psychology 101 textbooks)?
>
> Or is it really not so bad after all.
>
> Just want to know in case I finally decide to give it a try.
> Scott
Posted by ivoovi on January 19, 2002, at 14:10:33
In reply to Depakote...An ugly Beast or gentle friend?, posted by mr.scott on January 18, 2002, at 13:06:14
I'm on Depakote 1000mg. I haven't noticed any weight gain yet...but I've only been back on it for a week (stopped it after being on it for two weeks...I thought I was gaining weight). It works very well, however, I know longer have the extensive vocabulary I once had. I also feel mentally foggy, as if I can't correctly work my brain...It's hard to conceptualize and understand more abstract things...
So...the only real side-effect I've noticed is cognitive trouble...does anyone know if this goes away with time?
Posted by ST on January 20, 2002, at 17:39:02
In reply to Re: Depakote...An ugly Beast or gentle friend? » mr.scott, posted by ivoovi on January 19, 2002, at 14:10:33
I think doctors tend to over medicate bi polars with their mood stabilizers - god forbid they become hypo manic or manic! They'd rather have us numb than suicidal or, on the other side of the spectrum, bouncing off the walls. I understand their thinking; they'd rather be "safe than sorry". However, my mental acuity rose considerably with each dose reduction of Depakote. Really keep after your pdoc about slowly lowering your doses. If your pdoc has been seeing you for awhile and begins to trust you, he/she may agree to lower it. When I get my levels tested, I'm way off-target for the recommended therapeutic level of Depakote. Yet, regardless of the numbers, I'm functioning fine and have not been manic in years.
This may not work for everyone and needs to be done with close supervision.
Sarah
> I'm on Depakote 1000mg. I haven't noticed any weight gain yet...but I've only been back on it for a week (stopped it after being on it for two weeks...I thought I was gaining weight). It works very well, however, I know longer have the extensive vocabulary I once had. I also feel mentally foggy, as if I can't correctly work my brain...It's hard to conceptualize and understand more abstract things...
> So...the only real side-effect I've noticed is cognitive trouble...does anyone know if this goes away with time?
Posted by Krazy Kat on January 20, 2002, at 18:08:17
In reply to Over medicating, posted by ST on January 20, 2002, at 17:39:02
Sarah:
I appreciate your post, but from my experience and from what I have read, I disagree strongly with you.
If the manic part of manic depression were "fun", none of us would seek help. Actually, it's destructive and often degrading.
I just tried to go off my stabilizer and exist on an SSRI - I felt worse than I have in years.
Bipolars are wired differently - we don't quite know How yet, but it is different than a depressive, who could benefit greatly from an AD alone.
Cetainly it is best to be at the lowest dose possible of any med - bipolars really have to be careful, though - mania tells you to stop meds altogether, that you are invincible - this is very dangerous.
- KK
Posted by Gracie2 on January 21, 2002, at 0:24:50
In reply to Depakote...An ugly Beast or gentle friend?, posted by mr.scott on January 18, 2002, at 13:06:14
I believe that Depakote has it's uses. I was precribed 500 mg daily for long-term anxiety and insomnia, which was destroying my health and personal relationships. Initially, Depakote helped to calm me down and regulate my sleep cycle
(for a dedicated insomnic, this is like winning at Powerball). However, after 6 months of taking the same dosage, my system became over-saturated with the drug and I grew terribly lethargic and disinterested in everything. My thinking slowed to the point where I could almost hear my IQ falling. As a medical worker who is often required to make quick and sometimes creative decisions, my professional life and the care of my patients suffered.I have no formal psychiatric training, but my uuprofessional opinion is that Depakote should be reserved as an initial treatment for patients in crisis - those who suffer from self-destructive tendencies and cannot function in daily life due to violent mood swings, panic attacks, OCD or disabilitating anxiety. After the patient shows signs of stabalizing, he should be tapered from the Depakote SLOWLY (it's powerful stuff) and his medication substituted by a drug known to have less profound and long-term effects. If you have established a trusting relationship with your doctor, he may prescribe some kind of benzodiazapene to be used PRN for break-through anxiety or insomnia, which I found to be quite helpful.
Again, this is my own opinion derived from my own experience, along with all the other usual disclaimers. My psychiatrist, who was from Pakistan, was quite young and I believe somewhat inexperienced. However, I continued to see her on a regular basis until she disappeared for a six- week vacation to get married in Pakistan and enjoy an extended honeymoon. While I would never begrudge her a personal life, she did not inform her patients that she was leaving or assign a doctor to see her out-patients while she was absent, according to her staff. They suggested I go to the emergency room if I was having a problem. Having worked with dozens, maybe hundreds of doctors over the course of my career,
I had never once seen a doctor who treated their patients in such a manner, and it struck me as being completely uncaring and unprofessional. I never saw her again, and I suspect the regimen of pyschiatric drugs that she prescribed for me may not have been the best. At the very least, I think Depakote usage should be closely monitered
so that the drug's benefits do not overrun their course.
-Mouthy
Posted by anniebananie on January 21, 2002, at 1:53:11
In reply to Over medicating, posted by ST on January 20, 2002, at 17:39:02
> I think doctors tend to over medicate bi polars with their mood stabilizers - god forbid they become hypo manic or manic!...When I get my levels tested, I'm way off-target for the recommended therapeutic level of Depakote. Yet, regardless of the numbers, I'm functioning fine and have not been manic in years.
I agree with you. Yes, there are some people who are in danger of quickly becoming manic if they are not on official therapeutic doses, but there are also plenty of us who do well, or even better, on less.
Annie
Posted by ST on January 21, 2002, at 4:25:40
In reply to Over medicating, posted by ST on January 20, 2002, at 17:39:02
KK,
You're right - it's a very difficult line for bi polars to walk. That's why at the end of my post I said:
> >This may not work for everyone and needs to be > >done with close supervision.
Someone who is already showing signs of mania on their current dose of mood stabilizer wouldn't be the right candidate for lowering dosage, and I'm sure no pdoc would agree to that. Watching one's own reactions to their dosage should be done responsibly, while under the care of a pdoc. Any decision to lower dosage should be done with their doctor's OK.
My point was that if you feel slow or numb on your current level of mood stabilizer, you don't have to settle for that and think you have to be a zombie the rest of your life! You can work with your doctor at finding the right dose.
Sarah
> I think doctors tend to over medicate bi polars with their mood stabilizers - god forbid they become hypo manic or manic! They'd rather have us numb than suicidal or, on the other side of the spectrum, bouncing off the walls. I understand their thinking; they'd rather be "safe than sorry". However, my mental acuity rose considerably with each dose reduction of Depakote. Really keep after your pdoc about slowly lowering your doses. If your pdoc has been seeing you for awhile and begins to trust you, he/she may agree to lower it. When I get my levels tested, I'm way off-target for the recommended therapeutic level of Depakote. Yet, regardless of the numbers, I'm functioning fine and have not been manic in years.
> This may not work for everyone and needs to be done with close supervision.
> Sarah
>
>
> > I'm on Depakote 1000mg. I haven't noticed any weight gain yet...but I've only been back on it for a week (stopped it after being on it for two weeks...I thought I was gaining weight). It works very well, however, I know longer have the extensive vocabulary I once had. I also feel mentally foggy, as if I can't correctly work my brain...It's hard to conceptualize and understand more abstract things...
> > So...the only real side-effect I've noticed is cognitive trouble...does anyone know if this goes away with time?
Posted by spike4848 on January 21, 2002, at 10:06:29
In reply to Re: Over medicating, posted by ST on January 21, 2002, at 4:25:40
Hey There,
Our disease is like any other. Some diabetics just need to modify their diet to stablize there blood sugar. Other need diet, up to three oral medication in combination and insulin injections to get control of their sugar levels.
Some of us here need very low doses of medication to stable us ..... level that may seem subtherapeutic ..... but that is all they need. Some of us need a combination of meds and intensive psychotherapy to help with our moods. Some need meds and ECT! Bipolar and unipolar disease definately come in varing degree.
I agree ..... overmedication is wrong .... even MALPRACTICE! Your stealing someone's life away when you over medicate an individual. Some pdoc forget we are try to live life outside of office visits.
Spike
Posted by mr.scott on January 21, 2002, at 11:37:47
In reply to Re: Depakote...An ugly Beast or gentle friend?, posted by Gracie2 on January 21, 2002, at 0:24:50
Wow! Thanks for sharing Gracie!!
Posted by Gracie2 on January 21, 2002, at 18:28:23
In reply to Re: Depakote...An ugly Beast or gentle friend? » Gracie2, posted by mr.scott on January 21, 2002, at 11:37:47
Posted by Krazy Kat on January 21, 2002, at 19:08:16
In reply to Re: Over medicating, posted by ST on January 21, 2002, at 4:25:40
Sarah:
Maybe it depends on the "degree" of BP -- my pdoc has said that I have a choice - to feel flattened at times, or to continue with these destructive swings. I don't think there's anything available yet that can keep one stable w/o the residual effect of some flatness - at least not for someone who can't tolerate the more activating meds, i.e. Lamictal, such as myself.
- KK
This is the end of the thread.
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