![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by g_g_g_unit on May 27, 2011, at 9:44:51
I know this is mostly a matter of individual trial-and-error, but could anyone perhaps offer rough guidance on a Depakote dosing regime that worked for them? Or at least corroborate my experience?
So far, I have been dosing (the instant-release version) before bed and have noticed bountiful dreaming and shallow, unrefreshing sleep. After I raised my dose to 400mg last night, I became noticeably energized and lay in bed for several hours before finally falling asleep.
Logic dictates taking it in the morning, I suppose, but I was just curious if anyone tried that without adverse consequences? My psychiatrist advised that the drug was usually sedating.
Posted by Christ_empowered on May 27, 2011, at 10:10:28
In reply to depakote dosing advice, posted by g_g_g_unit on May 27, 2011, at 9:44:51
I dunno man. I had to take a hefty dose of Depakote for acute psychotic mania, and I hated the stuff. Started at 1500, all at once in the AM, ended up on 1000 of the xr b/c my blood levels got too high on 1500mgs of the instant release.
I think you should try talking to your doc about getting some blood work. If you're not hitting a high enough level, you're basically just using a decidedly unpleasant sedative. Go too high for whatever issue you have, and you're a) dumbing yourself down and b) risking side-effects and toxicity (depending on how high you go).
If you have insurance, I'd really, really recommend the xr. The er...whatever, its not that great. But the xr is about as gentle as depakote gets and if you take it with dinner you should be calming down in time for bed and then it'll still be calming you down in the AM. The only downside is that I think with the xr you sometimes have to push the dose up a little to get to the same blood level, but if you're taking small amounts anyway that shouldn't be a huge deal.
Good luck!
Posted by g_g_g_unit on May 27, 2011, at 10:34:09
In reply to Re: depakote dosing advice, posted by Christ_empowered on May 27, 2011, at 10:10:28
Hey, thanks for replying. It only looks like the 500mg EC (modified-release?) tablets are available in Australia. Maybe he plans on switching me over once I reach a high enough dose; given that I'm pretty sensitive to medication, I've been going up in 100mg increments.
When you were taking 1000mg in the morning, did it noticeably sedated you, or were you still able to function during the day?
100-400mg before bed has been consistently messing up my sleep, so I'm torn between dosing all in the a.m., or splitting between a.m. and p.m.?
I'm also on 25mg of Zoloft, which I began before the Depakote, and which contributed to my insomnia, so it's hard to know if the Depakote is indeed a culprit, or just not *improving* my sleep.
Posted by Christ_empowered on May 27, 2011, at 12:35:59
In reply to Re: depakote dosing advice » Christ_empowered, posted by g_g_g_unit on May 27, 2011, at 10:34:09
hey. when I took 1500mgs in the day, I was calmed down but not really sedated. Then again...I was in a mental hospital, and they were trying to keep me as docile as possible. Probably not what you're going for.
When I was doing outpatient treatment w/ Depakote, I took 1000mgs of the xr with dinner. I still hated it, but it did calm me down before bed so I didn't need sleeping pills quite as often.
My guess would be that your depakote dose just isn't enough to get you to sleep. Maybe you still have some agitation from the zoloft, maybe its some underlying issue, I don't know. If it was me, I'd take it with dinner (food will help keep you from vomiting up the depakote later) and see if that helped. You might need a different antidepressant or a sleeping pill for a little while if you're still not sleeping.
So..does your doc think you're bipolar? Or is he gung-ho on the zoloft and just trying to calm you down enough so you can tolerate it? If you're still having problems from such a low dose of zoloft even with a little bit of depakote added, I'd ask about switching antidepressants, or just not using antidepressants at all. Not everybody needs a re-uptake inhibitor in their life.
Sorry you're going through a rough patch, and I hope you find a solution to your issues.
Posted by g_g_g_unit on May 28, 2011, at 3:36:31
In reply to Re: depakote dosing advice, posted by Christ_empowered on May 27, 2011, at 12:35:59
Thanks. I always appreciate your responses to my questions. I wish I could be more proactive around here, but it's difficult because I'm either struggling to feel well or too concerned with returning to 'real life'.
> hey. when I took 1500mgs in the day, I was calmed down but not really sedated. Then again...I was in a mental hospital, and they were trying to keep me as docile as possible. Probably not what you're going for.
I tried taking 200mg this morning with breakfast. It may have been coincidental, but I've been feeling more tired, lethargic and a little 'out of it' since (though the Depakote has that effect on me in general). Either way, I've just been lying around all day.
>
> When I was doing outpatient treatment w/ Depakote, I took 1000mgs of the xr with dinner. I still hated it, but it did calm me down before bed so I didn't need sleeping pills quite as often.
>
> My guess would be that your depakote dose just isn't enough to get you to sleep. Maybe you still have some agitation from the zoloft, maybe its some underlying issue, I don't know. If it was me, I'd take it with dinner (food will help keep you from vomiting up the depakote later) and see if that helped. You might need a different antidepressant or a sleeping pill for a little while if you're still not sleeping.Hmm, thanks for the suggestion. Yeah, it's weird .. when I take it at night, I feel dopey, calm, yet also energized at times. I had the same reaction to Neurontin. I'll try taking it with dinner for a couple of nights, like you suggest, and see what happens.
>
> So..does your doc think you're bipolar? Or is he gung-ho on the zoloft and just trying to calm you down enough so you can tolerate it? If you're still having problems from such a low dose of zoloft even with a little bit of depakote added, I'd ask about switching antidepressants, or just not using antidepressants at all. Not everybody needs a re-uptake inhibitor in their life.Um, he's never specifically come out and said that he thinks I'm bipolar. After I told him that combining Zoloft with caffeine was causing panic-like symptoms, he suggested that I could do with a little "dampening of excitatory neurotransmission." I don't think it was an unreasonable suggestion because most ADs and stimulants I've been trying lately have been causing agitation.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.