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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Sonya on June 9, 2005, at 18:28:18
I've been on 1000mg Depakote daily for 8 months. I also take 50mg Seroquel at bedtime for sleep and anxiety. I was diagnosed Bipolar II last year after a hospitalization. Lately I'm so tired, apathetic and especially lethargic that everything is an effort. I don't know whether the lethargy is because of returning depression or a side effect I'm now experiencing from Depakote. Will see my pdoc in 3 weeks about this. Anyone heard of Depakote causing depression?
Posted by linkadge on June 9, 2005, at 19:10:10
In reply to Depakote causing depression??, posted by Sonya on June 9, 2005, at 18:28:18
Yes, depakote can cause depresson. Make sure you take folic acid supplements since this is the main nutrient that anticonvulsants (including depakote) can depleat which can contribute to depression.
But, yes, talk to your doctor about perhaps some adjustment.
Linkadge
Posted by cache-monkey on June 9, 2005, at 20:41:17
In reply to Depakote causing depression??, posted by Sonya on June 9, 2005, at 18:28:18
I started Depakote (ER) a couple months ago. Doses above 500 mg seemed to make me a) depressed, and b) cognitively dulled.
I think that might have even initially occurred at 500 mg, but after shooting up to 1500 mg and then tapering back down to 500 mg again, it doesn't seem to be an issue.
But, it's odd that this would be showing up for you after 8 months of use. Thing is with Depakote is that it's much better on the manic and cycling side of things. It doesn't seem to be so good at preventing relapse into depression (or dysthymia), which is what might be going on with you.
If it's not so bad, keep an eye on things and see how they go. One thing you might want to consider with your pdoc is going up on the Seroquel, if you can handle the sedation. Higher doses (e.g. 300 mg+) have been shown to have really strong positive effects for depression in bipolars. If things aren't that bad, though, you might not need to go up too high.
Good luck,
cache-monkey> I've been on 1000mg Depakote daily for 8 months. I also take 50mg Seroquel at bedtime for sleep and anxiety. I was diagnosed Bipolar II last year after a hospitalization. Lately I'm so tired, apathetic and especially lethargic that everything is an effort. I don't know whether the lethargy is because of returning depression or a side effect I'm now experiencing from Depakote. Will see my pdoc in 3 weeks about this. Anyone heard of Depakote causing depression?
Posted by Phillipa on June 9, 2005, at 21:32:54
In reply to Re: Depakote causing depression?? » Sonya, posted by cache-monkey on June 9, 2005, at 20:41:17
Yes, 50mg of seroquel for sleep didn't do it for me. An additional 50mg in the middle of the night left me drunk. Maybe if it had been higher at bedtime it would have worn off. Fondly, Phillipa
Posted by theo on June 9, 2005, at 21:53:06
In reply to Depakote causing depression??, posted by Sonya on June 9, 2005, at 18:28:18
> I've been on 1000mg Depakote daily for 8 months. I also take 50mg Seroquel at bedtime for sleep and anxiety. I was diagnosed Bipolar II last year after a hospitalization. Lately I'm so tired, apathetic and especially lethargic that everything is an effort. I don't know whether the lethargy is because of returning depression or a side effect I'm now experiencing from Depakote. Will see my pdoc in 3 weeks about this. Anyone heard of Depakote causing depression?
Yes, I recently stopped Depakote because of doom and gloom feeling it gave me. Depakote is truly what they say, antimanic med, which I'm not. I was just trying it for anxiety and it made it worse also.
Posted by Sonya on June 10, 2005, at 7:24:02
In reply to Re: Depakote causing depression?? » Sonya, posted by theo on June 9, 2005, at 21:53:06
Thank you all for your feedback.
I'd also heard that Depakote was good for mania; not as good for depression. I was always more depressed and only hypomanic as a result of taking antidepressants (tried almost every one known to man with no good lasting results) and that's why I really don't think I even need to be on a drug for bipolar disorder...I don't think I'm bipolar!
I'm not too bad now so will wait to discuss with my pdoc in 3 weeks.
Posted by BIGDaddyachmed69 on June 10, 2005, at 9:57:29
In reply to Depakote causing depression??, posted by Sonya on June 9, 2005, at 18:28:18
> I've been on 1000mg Depakote daily for 8 months. I also take 50mg Seroquel at bedtime for sleep and anxiety. I was diagnosed Bipolar II last year after a hospitalization. Lately I'm so tired, apathetic and especially lethargic that everything is an effort. I don't know whether the lethargy is because of returning depression or a side effect I'm now experiencing from Depakote. Will see my pdoc in 3 weeks about this. Anyone heard of Depakote causing depression?
I was diagnosed with Bipolar I during a stay at the hospital a year ago, and as far as I know it was a misdiagnosis. My psychiatrist, whom I've been seeing for five and a half years, doesn't seem to think I'm bipolar. Regardless, I've been on Depakote ER ever since...2000 mg at night. I've experienced all of the symptoms you described, and tend to think the lethargy is a side effect. Depakote should theoretically prevent your depression from returning. But I know lethargy tends to cause you to feel kind of "down", overall. I'm on an antidepressant, which should be helping with that.
Posted by Sonya on June 10, 2005, at 12:52:48
In reply to Re: Depakote causing depression??, posted by BIGDaddyachmed69 on June 10, 2005, at 9:57:29
> I was diagnosed with Bipolar I during a stay at the hospital a year ago, and as far as I know it was a misdiagnosis. My psychiatrist, whom I've been seeing for five and a half years, doesn't seem to think I'm bipolar. Regardless, I've been on Depakote ER ever since...2000 mg at night. I've experienced all of the symptoms you described, and tend to think the lethargy is a side effect. Depakote should theoretically prevent your depression from returning. But I know lethargy tends to cause you to feel kind of "down", overall. I'm on an antidepressant, which should be helping with that.
Why do you think you were misdiagnosed? I think the same about myself, but *sigh* what's in a diagnosis? If you don't mind me asking, what landed you in the hospital last year? Is your antidepressant helping? I already told my pdoc I want off depakote but he is discouraging it but will go along if I insist. I don't know what to do. Do you really feel you need the depakote?
Posted by BIGDaddyachmed69 on June 10, 2005, at 15:18:47
In reply to bipolar misdiagnosis? » BIGDaddyachmed69, posted by Sonya on June 10, 2005, at 12:52:48
> Why do you think you were misdiagnosed? I think the same about myself, but *sigh* what's in a diagnosis? If you don't mind me asking, what landed you in the hospital last year? Is your antidepressant helping? I already told my pdoc I want off depakote but he is discouraging it but will go along if I insist. I don't know what to do. Do you really feel you need the depakote?
If I wasn't, they were probably wrong about which Bipolar disorder I have. I suffer from severe bouts of depression, and don't believe I've ever had mania. I may have had hypomanic episodes. My hospitalization was drug-related, and I'm pretty sure my history of substance abuse had a lot to do with their diagnosis. They determined I was cycling through bouts of drug abuse. I would use when I could feel myself descending into another depressive episode. I don't do drugs anymore. I'm on an MAOI now and the risk of a fatal drug interaction is enough to stop me from even considering it. The Depakote helps me control my temper, and seems to take the edge off of my anxiety. I haven't gone through a major depression since I started taking it, but I've been on Paxil up until now. I have been depressed on Paxil in the past. I think I could be feeling worse than I am, which is basically just somewhat apathetic. I've been feeling a little better since I started taking Nardil, which was a last resort. I'm afraid to go off of Depakote and find out that it was keeping me from sliding right back into depression. I might give it a try once I'm sure the antidepressant's working.
Posted by bipolarspectrum on June 11, 2005, at 19:55:47
In reply to Re: Depakote causing depression??, posted by BIGDaddyachmed69 on June 10, 2005, at 9:57:29
Check this out babblers:
Divalproex in the treatment of bipolar depression: a placebo-controlled study.
Davis LL, Bartolucci A, Petty F.
Veteran's Affairs Medical Center (151), 3701 Loop Road East, Tuscaloosa, AL 35404, USA. lori.davis@med.va.gov
BACKGROUND: The treatment of bipolar disorder in the depressed phase is complicated by a tendency for conventional antidepressant drugs to worsen the course of the illness by precipitating a manic episode or increasing cycle frequency. Thus, the potential antidepressant efficacy of mood stabilizers, such as divalproex, which is an effective treatment for the manic phase of bipolar disorder, is of considerable interest. METHODS: The clinical efficacy of divalproex (valproate, Depakote) was tested in an 8-week, double-blind, placebo-controlled, randomized clinical trial in 25 outpatients with bipolar I depression. The primary outcome measure was the 17-item Hamilton Rating Scale for Depression, and secondary measures included the Hamilton Rating Scale for Anxiety, the Clinician Administered Rating Scale for Mania, and the Clinical Global Impression scale. RESULTS: Using repeated measures ANOVA with last observation carried forward, divalproex was more effective than placebo in improving symptoms of depression (p = 0.0002) and symptoms of anxiety (p = 0.0001) than placebo. LIMITATIONS: The sample size was small, and most patients were male. CONCLUSIONS: These pilot results indicate that divalproex is effective in reducing the symptoms of depression and anxiety in bipolar I, depressed phase. These positive results support the need to perform a larger, multisite study of divalproex treatment for bipolar depression.
Posted by SLS on June 12, 2005, at 6:51:00
In reply to Depakote may HELP bipolar depression!!!!!!!!!!, posted by bipolarspectrum on June 11, 2005, at 19:55:47
> Check this out babblers:
I don't doubt that valproate can effect a robust antidepressant effect for some people. For them, it is the right drug. I noted that the population they tested were bipolar I. My guess is that bipolar I is more amenable to the antidepressant effects of both lithium and valproate - more so than of bipolar II. Just a guess. The majority of bipolars here at PB seem to be type II. This might account for the disparate clinical impression between the study and the population here, who often have representatives who feel more depressed on valproate.
Valproate tickled my brain once and produced an antidepressant effect, so I believe it does have that potential.
- Scott
>
> Divalproex in the treatment of bipolar depression: a placebo-controlled study.
>
> Davis LL, Bartolucci A, Petty F.
>
> Veteran's Affairs Medical Center (151), 3701 Loop Road East, Tuscaloosa, AL 35404, USA. lori.davis@med.va.gov
>
> BACKGROUND: The treatment of bipolar disorder in the depressed phase is complicated by a tendency for conventional antidepressant drugs to worsen the course of the illness by precipitating a manic episode or increasing cycle frequency. Thus, the potential antidepressant efficacy of mood stabilizers, such as divalproex, which is an effective treatment for the manic phase of bipolar disorder, is of considerable interest. METHODS: The clinical efficacy of divalproex (valproate, Depakote) was tested in an 8-week, double-blind, placebo-controlled, randomized clinical trial in 25 outpatients with bipolar I depression. The primary outcome measure was the 17-item Hamilton Rating Scale for Depression, and secondary measures included the Hamilton Rating Scale for Anxiety, the Clinician Administered Rating Scale for Mania, and the Clinical Global Impression scale. RESULTS: Using repeated measures ANOVA with last observation carried forward, divalproex was more effective than placebo in improving symptoms of depression (p = 0.0002) and symptoms of anxiety (p = 0.0001) than placebo. LIMITATIONS: The sample size was small, and most patients were male. CONCLUSIONS: These pilot results indicate that divalproex is effective in reducing the symptoms of depression and anxiety in bipolar I, depressed phase. These positive results support the need to perform a larger, multisite study of divalproex treatment for bipolar depression.
>
Posted by barbaracat on June 12, 2005, at 22:06:52
In reply to Depakote causing depression??, posted by Sonya on June 9, 2005, at 18:28:18
I was switched to Depakote and Seroquel last January after a hospital stay. I had been on lithium but my hypothyroid condition had worsened. Long story short, I HATED depakote. It was touted as an antianxiety along with antimanic but made me sluggish, apathetic, crabby, plus my hair started falling out. I also hated Seroquel which made me very tired. The two together and I could barely move out of my chair. It was a very murky place without light or hope.
Went back on lithium and the difference was profound.
Posted by SLS on June 13, 2005, at 7:11:32
In reply to Re: Depakote causing depression?? » Sonya, posted by barbaracat on June 12, 2005, at 22:06:52
> I was switched to Depakote and Seroquel last January after a hospital stay. I had been on lithium but my hypothyroid condition had worsened.
Is there anything you can do to help support thyroid function? Iodine? Probably not. I guess if there were some way to prevent thyroid dysfunction due to lithium treatment, we would have heard about it by now. Maybe. Perhaps you can go over to the Alternative board and ask if there are any supplements that would help.
Have you ever tried Lamictal? You could stay on the lithium and add it very gradually. Once you reach 200mg, you can then begin to VERY gradually taper the lithium. I've seen this strategy work for someone with bipolar I disorder who developed thyroid toxicity on lithium.
- Scott
Posted by PM80 on June 13, 2005, at 9:41:02
In reply to Depakote may HELP bipolar depression!!!!!!!!!!, posted by bipolarspectrum on June 11, 2005, at 19:55:47
Yes, Depakote clearly helped my depression. I was on nothing - not so great obviously, then I was on Seroquel (great for racing thoughts, restlessness, etc). But I still was depressed (drinking and SI regularly) and so my doc added Depakote in addition to the seroquel, and the difference was undeniable for me - almost from day 1.
I read somewhere else that it helps agitated types of bipolar depression, like that seen in a mixed episode.
Posted by barbaracat on June 13, 2005, at 19:49:05
In reply to Re: Depakote causing depression?? » barbaracat, posted by SLS on June 13, 2005, at 7:11:32
Sigh, I wish there were something that would help for thyroid support but nothing is enough except meds. I've tried everything, from blue flag calamus to L-tyrosine to guggul to ayurveda and on and on. I have a family history of it and there are enough other environmental reasons out there. I have high mercury and mercury displaces thyroid molecules. Did you know that flouride is very toxic to the thyroid gland? So are many pesticides. So even if I didn't have a genetic reason, there are other's that are culpable.
Iodine doesn't help unless you're deficient in iodine and we with our vitamins and such aren't. No, it's more a receptor competition thing and/or an autoimmune problem. I keep my levels on the 'hot' side because when I start getting even a little low my fibromyalgia pains and depression symptoms come back bad.
Lamictal: I was taking Lamictal for about a year and doing pretty well on it combined with lithium. I was only on 75mg and it was enough, given my ultra-sensitive drug reponse (except for benzos which I can gulp by the handful). Then my Mom died and I went into a bad tailspin. My pdoc raised it up to 150mg with no appreciable relief in my depression. And then I began to itch like a dog with fleas. Bad, bad itching. Neither of us associated it with 'the rash', but that's what it was. I came down with Steven's Johnson Syndrome shortly AFTER I stopped lamictal but started a sulfa antibiotic. I know the itching was the prodromal stage and it didn't take much to tip the scales, although I never was allergic to sulfa drugs before.
So no, I won't be doing lamictal again. I'm very happy with my 600mg Lithium, 06mg Cymbalta and my Synthroid/Cytomel combo. And a handful of benzos when I need them.
>
> Is there anything you can do to help support thyroid function? Iodine? Probably not. I guess if there were some way to prevent thyroid dysfunction due to lithium treatment, we would have heard about it by now. Maybe. Perhaps you can go over to the Alternative board and ask if there are any supplements that would help.
>
> Have you ever tried Lamictal? You could stay on the lithium and add it very gradually. Once you reach 200mg, you can then begin to VERY gradually taper the lithium. I've seen this strategy work for someone with bipolar I disorder who developed thyroid toxicity on lithium.
>
>
> - Scott
Posted by Rea1 on June 14, 2005, at 23:47:54
In reply to Depakote may HELP bipolar depression!!!!!!!!!!, posted by bipolarspectrum on June 11, 2005, at 19:55:47
i was diagnosed with epilepsy when i was 15(petite mal siezures). the medication that the dr put me on was depakote. one thing that i did notice was a decrease in my depression. i am not bipolar, but have suffered from depression. i dont know what it was, but it did help. it could be that it enabled me to think a little more clearly. my siezures were caused by an overload of information. my brain couldnt handle all the input at once and would "short circuit" thus, causing a siezure. the depakote stopped my brain from short circuiting, and enabled me to think, rather than have a siezure. i could then think through my situation, and i wasnt so depressed. funny thing is, now i have been diagnosed with generalized anxiety disorder, so i'm thinking too much. i'm no longer on depakote and no longer having siezures, but i would recommend trying depakote to help with depression.
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