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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 36. This is the beginning of the thread.
Posted by Robert Johnson on January 22, 2002, at 14:47:18
Several questions for bipolars who have taken Depakote for more than three months:
1. Do the side effects (e.g., sedation, appetite increase, mental slowing, etc.) tend to diminish with time?
2. Have you tried both Depakote and Depakote ER? Does the ER (Entended Release) version have fewer side effects?
Posted by TSA West on January 22, 2002, at 21:56:24
In reply to Depakote Side Effects, posted by Robert Johnson on January 22, 2002, at 14:47:18
Depakote ER had no side-effects in the last user I heard from, but it was significantly more expensive and not covered by HMO insurance. Regular Depakote can be taken all at bedtime according to Dr. Bob's colleagues: http://www.dr-bob.org/tips/split/Giving-valp-all-at-hs.html
Posted by Robert Johnson on January 23, 2002, at 9:22:52
In reply to Re: Depakote Side Effects » Robert Johnson, posted by TSA West on January 22, 2002, at 21:56:24
> TSA West,
Thanks for the information.
My bipolar 1 wife is a teacher. She's been taking Depakote for the first time in her life for the past month. Since she has always had terrible insomnia problems, the sedative and mood stabilization effects of Depakote have been a real blessing for her. For the first time in decades, she has now been averaging 8+ hours of sleep at night. The problem is the daytime.
She has a rather irregular work schedule. Although she does not work continuously during the day, on some days she can start work as early as 7:30 a.m. and not be completely finished until 7:30 p.m. The trick is trying to keep her awake and mentally alert (not "foggy") on Depakote throughout the day. We'll see if your suggestion about taking all the drug at night helps her or not.
We were, however, still wondering whether the side effects of the drug (including the mental "fogginess") tended to wear off over time for long term users or, if not, whether Depakote ER might still be a better way to go for her.
We'd still deeply appreciate hearing additional feedback/suggestions from other bipolars or docs out there who have personal experience to share.
p.s. If Depakote ER is best way to go on this, we'd be more than willing to pay the $35 co-pay that my insurance policy would charge us for it.
Posted by Krazy Kat on January 23, 2002, at 10:51:36
In reply to Depakote Side Effects, posted by Robert Johnson on January 22, 2002, at 14:47:18
Robert:
"Do the side effects (e.g., sedation, appetite increase, mental slowing, etc.) tend to diminish with time?"
The appetite increase did not decrease for me - it's been just about 3-1/2 months. Am having some trouble with sedation this time around (I had stopped it for a few days) and hand tremors again.
"2. Have you tried both Depakote and Depakote ER? Does the ER (Entended Release) version have fewer side effects?"
I've never tried ER but that's a good question!
- KK
Posted by susan C on January 23, 2002, at 13:08:39
In reply to Depakote Side Effects, posted by Robert Johnson on January 22, 2002, at 14:47:18
> Several questions for bipolars who have taken Depakote for more than three months:
>
> 1. Do the side effects (e.g., sedation, appetite increase, mental slowing, etc.) tend to diminish with time?Length of time on Depakote EC, 14 months: for me, yes, but there is some anyway so regards mental slowness it is hard to say. I do not now noticed fatigue when I take my morning dose.
I did not gain weight, I have lost weight, which I needed to do anyway...here is to drinking those eight glasses of water a day, or trying to, anyway.
>
> 2. Have you tried both Depakote and Depakote ER? Does the ER (Entended Release) version have fewer side effects?I take, (wait a sec, let me go read the bottle) Depakote EC, Enteric Coated, which means it is covered with something that gets it through the stomach before it dissolves therefore minimizing stomach upset...(which I never noticed at the beginning and I take it on an empty stomach) when I asked peadoc about difference between EC and ER extended release, he said, it is just a way for the companies to charge more, that by the time it gets to your brain, it is all the same. Might this be why your insurance company won't cover ER?
I know this has been posted here before and some people swear by the ER version...I have not taken it however. Depakote EC helps even out my mood.
Mouse balancing on the pill bottle
Posted by Krazy Kat on January 23, 2002, at 13:22:13
In reply to Re: Depakote Side Effects, posted by susan C on January 23, 2002, at 13:08:39
Mouse:
Do you ever get a pain in your way lower right side? It's not up near the organs, more by the ovar-ies. Sorry, kind of personal there. :)
Just wondering and wandering...
- KK
Posted by Robert Johnson on January 23, 2002, at 14:37:58
In reply to Re: Depakote Side Effects, posted by susan C on January 23, 2002, at 13:08:39
> Length of time on Depakote EC, 14 months: for me, yes, but there is some anyway so regards mental slowness it is hard to say.
_______________________________________Susan,
I'm inferring from your above response the following:
1. Appetite increase tended to diminish with time;
2. Sedation tended to diminish with time;
3. You are unsure whether the mental slowing has improved or not.
Is this correct? If yes, how long were you on Depakote before you started to notice the improvements? Thanks.
Posted by susan C on January 23, 2002, at 17:34:42
In reply to Re: Depakote Side Effects, posted by Robert Johnson on January 23, 2002, at 14:37:58
> > Length of time on Depakote EC, 14 months: for me, yes, but there is some anyway so regards mental slowness it is hard to say.
> _______________________________________
>
> Susan,
>
> I'm inferring from your above response the following:
>
> 1. Appetite increase tended to diminish with time;no, I never gained weight (tho I was already 30-40lb overweight). my peadoc struck the fear of god in me when starting, so i vigourously walking, drinking water and watching diet (I loose 5lbs if i stop cheese and butter 8;) I also saw him a couple or one times a month and he asked about my weight. So from about month 7 to 14 i lost 20lbs. This is complicated by starting another antiseisure med during month ten which resulted in a complete loss of appetite which resulted in a loss of 10lbs over a period of a month or so , oh, and dont forget menopause...hmmmmm
> 2. Sedation tended to diminish with time;
The first 4 weeks of starting,I charted my mood and noticed an overall difference to previous months (other trials of Mood Stablizers)improvement about 25%. For me, not dramatic, but enough that the swings (I rapid cycle sometimes within each day) were and are not as severe.
Note, during the initial months one and through four I was increasing my dosage...to a high of 1500mg a day (750 2x a day) in month four. During those four months I was dizzy, disoriented, fatigued. I realized I really didn't see any difference in mood, so we agreed to go to 1000. I have been there since month four, so, ten months at one consistant dose. I am a vetern med trial patient. Perhaps too patient. Now I think four weeks is maximum to try a med. If it isn't showing help by then, out it goes.
I cant remember when the result of staying at the one dose of 1000mg evened out as far as fatigue/drowsiness, i will need to think about that. I do know at month nine (so I had been on 1000mg for five months) I had a terrible agitated episode. We talked about me having the option to go up in dose, but, because of the way my blood tests show the use of depakote. I can not/do not utilize more.
> 3. You are unsure whether the mental slowing has improved or not.
Mental slowing, cognitive dullness, is a part of my puzzle. It is why as I understand it, that my peadoc thinks my mood disorder is seizure related. It comes and goes. It has always come and gone. Now, maybe always, it is clearly a daily experience, stress triggered and genetic.
>
> Is this correct? If yes, how long were you on Depakote before you started to notice the improvements?I noticed mood stabilization within 4 weeks of initially starting. I would say, when I finalized my dosage, results have basically (some "break throughs")been consistant.
I qualify all this with the caveate (sp?) that i have heard from all bipolar two. I love part of the 'up' part of my illness. It is the uncontrollable swing, up, then crashing afterwards with no even in between, that is so frightening.
There is a quality described as 'flatness' to taking this medication, that I am still trying to understand. It isnt drowsiness, it isn't fatigue, but, at this point I prefer it to the agitation, mixed moods. It is in a way, that i need to learn "me" again.
< Thanks.
you are welcome, thank you for getting me to think about this particular combination of things. This is why I come here and participate.
Please feel free to ask me more questions.
Mouse with her thinking cap on
Posted by tina on January 23, 2002, at 18:27:52
In reply to Depakote Side Effects, posted by Robert Johnson on January 22, 2002, at 14:47:18
>
> 1. Do the side effects (e.g., sedation, appetite increase, mental slowing, etc.) tend to diminish with time?Funny, I haven't had any of these side effects. IN fact, I've lost weight, am mentally more alert and it doesn't make me tired at all. I guess it depends on how your body is affected by it. Hmmm. Wild.
The only side effect I've had is upper abdominal pain. Like lactose intolerance. I hope THAT goes away soon.
Posted by OldSchool on January 23, 2002, at 18:40:23
In reply to Depakote Side Effects, posted by Robert Johnson on January 22, 2002, at 14:47:18
> Several questions for bipolars who have taken Depakote for more than three months:
>
> 1. Do the side effects (e.g., sedation, appetite increase, mental slowing, etc.) tend to diminish with time?Nope...the side effects hang around as long as you are on the drug.
>
> 2. Have you tried both Depakote and Depakote ER? Does the ER (Entended Release) version have fewer side effects?I took regular depakote briefly several years back. I wouldnt think the side effects would be much different for the ER version, however the fact you only need to take it once a day would be a major advantage over the original depakote.
Depakote is a good drug for many things and its side effects should be overlooked if you are really ill. As long as you have regular liver profile tests done like you are supposed to, its a very safe drug. One rule to follow on depakote is DO NOT drink booze! Drinking booze is a major no no on depakote
Old School
Posted by Robert Johnson on January 24, 2002, at 9:00:12
In reply to Re: Depakote Side Effects, posted by tina on January 23, 2002, at 18:27:52
> >
> > > The only side effect I've had is upper abdominal pain. Like lactose intolerance. I hope THAT goes away soon.
________________________________________________You probably already know this, but be sure to pay attention to abdominal pain when using Depakote. Although rare, there have been some cases of life threatening acute pancreatitis and liver toxicity associated with the use of this drug. If you want additional information on this, you can access the following link for further details:
http://www.citizen.org/ELETTER/ARTICLES/divalproex.htm
Posted by anniebananie on January 25, 2002, at 14:26:46
In reply to Re: Depakote Side Effects, posted by Robert Johnson on January 23, 2002, at 9:22:52
> She has a rather irregular work schedule. Although she does not work continuously during the day, on some days she can start work as early as 7:30 a.m. and not be completely finished until 7:30 p.m. The trick is trying to keep her awake and mentally alert (not "foggy") on Depakote throughout the day. We'll see if your suggestion about taking all the drug at night helps her or not.I know it's okay to take all your depakote at night, but I'd be careful, especially on an irregular schedule. I don't know whether this would have been true with the ER version, but when I took all my depakote at night, I had a hell of a time waking up in the morning & often slept thru two alarm clocks (my neighbors loved that, as did my co-workers).
Annie
Posted by colin wallace on July 23, 2002, at 7:33:40
In reply to Re: Depakote Side Effects, posted by Robert Johnson on January 24, 2002, at 9:00:12
I've just returned from a long awaited, marginally disappointing consultation with a psychiatrist.Disappointing because, although he seemed a decent enough guy, English was not his first spoken language, and in an interview where nuances can be so important(in my lowly opinion)-I feel much may have been missed, as striking a rapport in these circumstances is more difficult.
However, my diagnosis for today is double depression, and due to my adverse, erratic and angry reactions to AD's, he's going to give Depakote a shot- at 200mg to start.
He didn't agree with (though in fairness, wouldn't dismiss)my bipolar type 11 theory, but declined my request for lithium because he felt that the small dose I wanted (300/600mg) would be unlikely to be beneficial.Most of his patients are on 1000mg or so.
Valproate, I understand, does not exert any standalone antidepressant or prophalactic effects, as does lithium ? And seeing as I'm depressed as hell and will only ever take another standard AD if my mouth is held open with forceps and a medieval catapult is used to force feed me, what's the point of a mood stabilizer alone?
Also, would I be wrong in thinking that lithium has a more benign side effect profile than valproate? I find the liver thing worrisome to say the least.
Still, its my call, and I'm edging towards refusing the stuff, and obtaining my own lithium-
then I'll just present myself and say, 'monitor my blood levels for lithium please- or don't 'cos I don't really care.Col.
Posted by PsychoPsychic on July 29, 2003, at 2:32:57
In reply to Re: Depakote , posted by colin wallace on July 23, 2002, at 7:33:40
I don't understand why the p-doc wants you on depakote. It's known to have depressive effects, and if he thinks you're 'double depressed' (What is that, by the way?) I don't know what he was thinking
...Just my opinion here, I wouldn't go back to a p-doc who prescribed only depakote for a person they think is depressed...
As far as I've read, you're right about lithium having some anti-depressant effects. Watch out for some of the 'natural' forms though, some of them can be more toxic than allopathic meds.
But about the side effects of lithium...
I have a friend whose father had to have part of his thyroid removed because of lithium damag. I haven't seen anything showing it has ALL the risks for toxidity that depakote does, but it can still cause some lovely liver damage, along with the risk to your thyroid gland and some nasty tremors.
Iit's also alot worse if you OD on lithium, and easier to do if you're not paying attention.-On a little ending note, about the depakote,one of the side effects are 'dancing eyes', so do I call my doc if my eyes quit moving? (they have,constantly since birth)
--hope the post wasn't too,long
Posted by joebob on July 30, 2003, at 20:12:04
In reply to Re: Depakote » colin wallace, posted by PsychoPsychic on July 29, 2003, at 2:32:57
Posted by Jonathan on July 30, 2003, at 21:07:32
In reply to Depakote and booze........are you sure? NM (nm), posted by joebob on July 30, 2003, at 20:12:04
Posted by trish01 on August 29, 2003, at 19:07:41
In reply to Re: Depakote » colin wallace, posted by PsychoPsychic on July 29, 2003, at 2:32:57
okay i was wondering if anyone has heard that depakote can cause your overies to stop working? first off let me say that i was on it for bipolar when i was about 15 and i am 17 now i have 6 month old son and i need to go back on my meds. so i am in some deprate talking too. i get so angrey for nothing sometimes and it bothers me so much its never my son but its my boyfriends friends and family i take it out on. so what should i do? take the risk of not being about to have kids ever again or should i take the chanse to lose my skin with another med called tryliptal or something like that liptal or something. i know both are really scarey. it scares me because i am so young and i am in love and i want more children with the guy i am with but if that happenes or if te other happenes i am either dead or no more babies. hmmm i am not sure sometimes it feels like there is nothing left. depakote was the only drug that worked good with me because i was on topamax welbutrin and depakote i was so nice now i am a witch again. the only person i am nice to is my lil boy but i don't know what to do sometimes. i feel like giving up sometimes you know. well can someone write back and say something to make me feel better please. thank you bye trish
Posted by katia on August 30, 2003, at 0:40:55
In reply to Re: Depakote, posted by trish01 on August 29, 2003, at 19:07:41
> okay i was wondering if anyone has heard that depakote can cause your overies to stop working?
Where is your source for this? I haven't heard anything about it.
Posted by galkeepinon on August 30, 2003, at 2:14:22
In reply to Re: Depakote, posted by trish01 on August 29, 2003, at 19:07:41
hi, yes, I heard from my doctor that Depakote can cause PCOS (Poly Cystic Ovarian Syndrome) in alot of women who take it.
I would suggest you talk things over with your doctor to find the best alternative for yourself:-)
All the best!
> okay i was wondering if anyone has heard that depakote can cause your overies to stop working? first off let me say that i was on it for bipolar when i was about 15 and i am 17 now i have 6 month old son and i need to go back on my meds. so i am in some deprate talking too. i get so angrey for nothing sometimes and it bothers me so much its never my son but its my boyfriends friends and family i take it out on. so what should i do? take the risk of not being about to have kids ever again or should i take the chanse to lose my skin with another med called tryliptal or something like that liptal or something. i know both are really scarey. it scares me because i am so young and i am in love and i want more children with the guy i am with but if that happenes or if te other happenes i am either dead or no more babies. hmmm i am not sure sometimes it feels like there is nothing left. depakote was the only drug that worked good with me because i was on topamax welbutrin and depakote i was so nice now i am a witch again. the only person i am nice to is my lil boy but i don't know what to do sometimes. i feel like giving up sometimes you know. well can someone write back and say something to make me feel better please. thank you bye trish
Posted by trish01 on August 30, 2003, at 18:14:33
In reply to Re: Depakote » trish01, posted by katia on August 30, 2003, at 0:40:55
well first of all i was on depakote for three years and nothing happened to me. it was when i got pregnant that my phychatrist told me that i can get some problem with my overies. so they were removing me anway. now i am in the dilema on what to do at all. because i think i really need something to keep my cool or i am rude, loud, and angrey all the time. i would really like to go back on it but i want to get some imformation about it. so i came here thinking that the doctor could give me some info then i read that he doesn't talk to us. so i was in a dilema again. i want more kids and i am not sure if i should take the risk. i am not sure where to look for the info because my doctor don't even know that much. well thank you for your help and i will talk to ya all later
Posted by Angielala on November 11, 2003, at 13:03:23
In reply to Re: Depakote all at night » Robert Johnson, posted by anniebananie on January 25, 2002, at 14:26:46
>
> > She has a rather irregular work schedule. Although she does not work continuously during the day, on some days she can start work as early as 7:30 a.m. and not be completely finished until 7:30 p.m. The trick is trying to keep her awake and mentally alert (not "foggy") on Depakote throughout the day. We'll see if your suggestion about taking all the drug at night helps her or not.
>
> I know it's okay to take all your depakote at night, but I'd be careful, especially on an irregular schedule. I don't know whether this would have been true with the ER version, but when I took all my depakote at night, I had a hell of a time waking up in the morning & often slept thru two alarm clocks (my neighbors loved that, as did my co-workers).
>
> Annie
>Annie- you just made me feel normal for the first time in years. I am pretty new on Depakote- just about a year now.... and you are the FIRST person to tell me that they too have had a hard time getting up in the morning. I thought it was just another bad habit to add to my list. Since being on Depakote, that's been the hardest thing in the world for me- waking up. I grew up being an insomniac and now, for the life of me, I can't wake up.
Posted by Angielala on November 11, 2003, at 13:47:58
In reply to Re: Depakote, posted by trish01 on August 30, 2003, at 18:14:33
> well first of all i was on depakote for three years and nothing happened to me. it was when i got pregnant that my phychatrist told me that i can get some problem with my overies. so they were removing me anway. now i am in the dilema on what to do at all. because i think i really need something to keep my cool or i am rude, loud, and angrey all the time. i would really like to go back on it but i want to get some imformation about it. so i came here thinking that the doctor could give me some info then i read that he doesn't talk to us. so i was in a dilema again. i want more kids and i am not sure if i should take the risk. i am not sure where to look for the info because my doctor don't even know that much. well thank you for your help and i will talk to ya all later
Hi Trish-
I had the same worries when my doc put me on depakote a year ago. I'm newly engaged and kids have always been planned on by both of us. It seems that everything I need to take for my bipolar has some side effect that includes the female reproductive system. After telling my doc that my worst fear, besides killing myself someday, would to never being able to have children. She commented that if I killed myself, I would either be leaving children behind or never having children anyways. She explained that I was the one that needed to feel better before reproducing.
Since you know that the meds work for you, and you can remember being happy and nice to everyone... consider them. Don't be afraid to hunt down a specialist too... I know what you mean about doctors- it never feels like they really now what they are talking about when they address Depakote or depression or bipolar specifically. If you can find a doc that has worked with hundreds of women whom have taken these meds and have produced happy families, I think you will find some piece of mind.
Hang in there... you might be feeling some post-pardum too, if I remember correctly you said you had a 6 month year old. Post Pardum can also be treated.
Everyone has the right to be happy and feel good... people like us just need to fight for it. And I'm saure you'll agree that your baby was worth that fight when you first started it :)
Posted by Angielala on November 11, 2003, at 14:07:14
In reply to Re: Depakote, posted by trish01 on August 29, 2003, at 19:07:41
> okay i was wondering if anyone has heard that depakote can cause your overies to stop working? first off let me say that i was on it for bipolar when i was about 15 and i am 17 now i have 6 month old son and i need to go back on my meds. so i am in some deprate talking too. i get so angrey for nothing sometimes and it bothers me so much its never my son but its my boyfriends friends and family i take it out on. so what should i do? take the risk of not being about to have kids ever again or should i take the chanse to lose my skin with another med called tryliptal or something like that liptal or something. i know both are really scarey. it scares me because i am so young and i am in love and i want more children with the guy i am with but if that happenes or if te other happenes i am either dead or no more babies. hmmm i am not sure sometimes it feels like there is nothing left. depakote was the only drug that worked good with me because i was on topamax welbutrin and depakote i was so nice now i am a witch again. the only person i am nice to is my lil boy but i don't know what to do sometimes. i feel like giving up sometimes you know. well can someone write back and say something to make me feel better please. thank you bye trish
trish- check this link out- then search for others like it....
http://www.psycheducation.org/hormones/Insulin/polycystic.htm
Posted by katia on November 11, 2003, at 14:31:54
In reply to Re: Depakote » trish01, posted by katia on August 30, 2003, at 0:40:55
> > okay i was wondering if anyone has heard that depakote can cause your overies to stop working?
>
> Where is your source for this? I haven't heard anything about it.HI Trish,
You were the first person to alert me to Depakote's risk of PolyCystic Ovarian Syndrome (PCOS). I told my doctor my concern (isn't it great that WE have to tell our doctors about potential side effects). He managed to rouse up some stats re: this. The # of woman on Depakote (including those who take it for seizure disorder) who are likely to get it is something like 30% and that's a conservative number.Needless to say I stopped Depakote almost two weeks ago? I added Lamictal and may add either Lithium or Trileptal. AND by the way, I've heard good things about Trileptal - a low side effect profile. I would definitely give this one a go. Maybe this is a good alternative for you.
good luck.
katia
Posted by bookgurl99 on November 12, 2003, at 8:08:41
In reply to Depakote Side Effects, posted by Robert Johnson on January 22, 2002, at 14:47:18
Hey all --
I've been on Depakote for about 2 months now. Things are going well as far as effectiveness, etc.
I'm also on Lexapro, 10 mgs every day (actually sometimes I just take it every other day -- every day causes lethargy for me. I told my doctor, he didn't mind).
So . . I lost 5 pounds the first month, as I was exercising and doing well and happy. But now, don't know if it's winter coming on or what, but I'm starting to feel hungry and tired more. I just want to lay in bed and be sad and eat.
Some of this could related to family-related stress (my partner needs a good job), and the recent death of a good friend.
What could I do to minimize Depakote's part in all this? Is it the kind of med where, once you eat something sweet, you just have to have the whole box?
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