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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 greywolf on May 12, 2006, at 15:45:31
Finally saw my new p-doc today. Out of the blue they offered an appointment on 24hrs notice because they had a cancellation. Otherwise, it would have been end of July. So that was cool. And he turned out to be a pretty nice guy, so that's another positive.
I do have a question though for Depakote vets. He switched me from Depakote EC to ER, and upped the dosage to 1500 mg/day via three 500 mg pills, all taken at bedtime. Now, my understanding is that the objective is to achieve a relatively steady-state therapeutic blood level, so taking everything at bedtime would seem to be ineffective given Depakote's 9 - 16 hour half-life. I think he's trying to give me better sleep, but it would appear to come at the expense of the blood level.
Am I misunderstanding this?
Posted by MidnightBlue on May 12, 2006, at 16:19:49
In reply to New Depakote rx advice needed, posted by greywolf on May 12, 2006, at 15:45:31
All I know is my pdoc recommended the same thing. Take it all at night. Less side effects during the day and better sleep at night. I was just on the regular though.
I think unless you are taking it for seizures, the timing is not as important. (Now that I've said that I'm sure someone will disagree with me!)
MB
Posted by blueberry on May 12, 2006, at 17:59:48
In reply to New Depakote rx advice needed, posted by greywolf on May 12, 2006, at 15:45:31
The ER version of depakote is extended release and will slowly release continuously throughout its journey through your digestive tract. So the half-life factor doesn't come into play. Blood levels stay consistent.
The ideal blood level is between 50 and 100 (can't remember what the units were). At 500mg ER my blood levels were 29. We all metabolize differently, but it sounds like 3 pills will put you in the upper end of the correct range.
Posted by greywolf on May 12, 2006, at 21:19:26
In reply to Re: New Depakote rx advice needed, posted by blueberry on May 12, 2006, at 17:59:48
Thanks for your responses. I thought it was funny that I'm taking all 3 at once, but I guess it's pretty common.
Posted by bipolarspectrum on May 12, 2006, at 22:50:13
In reply to New Depakote rx advice needed, posted by greywolf on May 12, 2006, at 15:45:31
Whatsup Grey,
I also take a large dose of depakote (2500 mg) but I consume it in a morning and evening dose.. they dont offer the extended release in canada, which allows for the once daily dosing... i think a bit benefit of taking it at night is that if u experience sedation from it, hopefully u will sleep through... just like the other posters said! I can't add much to what they said as i think they are, as usual, bang on.. but it seems that the general consensus is that taking a full dose at night is optimal! good luck!
bps
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