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What is Depakote?

Depakote is an antiepileptic drug. It treats focal impaired-awareness seizures, complex partial seizures, and complex absence seizures. Doctors also prescribe Depakote for acute manic bipolar disorder symptoms and migraines.

What is Depakote’s generic name?

There are three generic names for Depakote: Divalproex sodium, valproate, and valproic acid.

How does Depakote work?

Depakote increases an inhibitory protein called gamma-aminobutyric acid (GABA). This protein works on your brain and nerves, specifically those linked to causing seizures and migraines. It can also act as a mood stabilizer and can be vital in alleviating acute mania in bipolar disorder.

What does Depakote treat?

Your doctor will administer Depakote if you experience epileptic seizures, migraines, or symptoms associated with bipolar disorder, including depression, lack of interest, insomnia, lack of appetite, lethargy, and lack or trouble of concentration. 

The drug is also helpful if you’re suffering from acute mania. Symptoms include irritability, intense excitement, extreme agitation, excessive talking, and intense activities.

How do you take Depakote?

The drug is available in various forms, including sprinkling capsules and tablets as delayed-release (DR) and extended-release (ER). 

Depakote delayed-release (DR) are Depakote Sprinkle Capsules. They are ideal for people who have difficulties swallowing, like most epileptic patients. Sprinkle it on soft food, apple sauce, pudding, or similar food products. You can also swallow them whole. They come in 125mg, 250mg, and 500mg.

Depakote ER (extended-release) works slowly and is available in 250mg and 500mg. 

Your dosage will depend on several factors, including your medical conditions, weight, and age.

Your doctor may monitor your blood levels of the drug to determine the dosage.

Epilepsy (for 10+)

The dosage is 10-15mg/kg per day for at least a week for monotherapy. It can be increased to 60mg/kg per day eventually.

Migraines (for adults)

The initial dose is 250mg orally, twice a day for delayed-release tablets, or 500mg daily for extended-release. Your physician can increase the dosage to 1,000mg per day total dosage if needed.

Bipolar disorder (for adults)

Generally, your doctor will prescribe a starting dose of 500-750mg per day. They can increase your dose to a maximum of 60mg/kg per day. Some doctors will use weight-based dosing of 20-30mg/kg per day, but this may result in high starting levels, and they may need to decrease it. Your doctor will usually monitor your blood levels and symptoms.

You may need to split the tablet along the score line if the doctor administers a dosage according to your weight.

Seeing results

You should see positive results in as little as a week or two. If your symptoms are better and you’re not suffering many side effects, it’s a sure sign that your body is responding well to Depakote.

However, consult your physician if more than a month has passed without any positive results or you’re experiencing unbearable side effects.

Potential side effects of Depakote

Common side effects of Depakote include:

  • Vomiting

  • Headache

  • Abdominal pains

  • Diarrhea

  • Sleep troubles, such as sleepiness or insomnia

  • Hair loss

  • Vision problems

Other side effects include:

  • Loss of appetite

  • Problems with motor coordination

  • Tremors and shaking

  • Weight gain

Rare but severe side effects include:

  • Developing liver problems

  • Having a low blood platelet count

  • Inflammation of the pancreas

  • Increased ammonia in the body: High ammonia levels could result in confusion and thinking and concentration difficulties.

The occurrence of suicidal thoughts is uncommon among those who take antiepileptic drugs. One estimate¹ says 1/500 who take Depakote have this experience.

Long-term use of Depakote

There are no known risks associated with the prolonged use of Depakote. Doctors and experts consider it safe when administered correctly and used as directed.

However, be wary of the possible side effects and report them to your doctor. You must attend regular check-ups to monitor your liver and pancreas.

Missed doses

Never double dose if you ever miss taking Depakote.

Overdoses

If you overdose on Depakote, you may feel sleepy, have an irregular heartbeat, or lose consciousness for a while. It is crucial to call a hotline such as the poison control center at 1-800-222-1222 or seek emergency medical care.

What to discuss with your doctor before you start taking Depakote

Here are some of the things you need to discuss before taking Depakote:

  • Other medication and supplements you are taking or planning to take. Depakote might interact with those medications and supplements and might result in other health problems or adverse effects.

  • Your alcohol intake. Inform your physician of your history of substance abuse, if any.

  • If you are pregnant, planning pregnancy, or currently breastfeeding.

  • If you have liver problems or other health issues such as diabetes.  

  • If you are undergoing some form of therapy for any mental health condition.

  • Your allergies to certain medications, if you have any.

  • If you have a genetic disorder called urea cycle disorder.

Stopping Depakote

You cannot just stop using Depakote as it may lead to your condition worsening, and it could increase your risk of seizures. Increased risk of relapse is a possibility. Your doctor will help you safely stop taking Depakote.

In case of severe side effects, immediately inform your doctor and get their instructions before you stop taking the drug.

Depakote and pregnancy

Depakote is pregnancy category D, which is where there is positive evidence of human fetal risk from studies. The potential benefits may outweigh the potential risks, but you should discuss this with your doctor.

There is a significant risk in taking the drug during pregnancy, and Depakote may harm the fetus and affect its development. Congenital disabilities, problems in children's mental development, low IQ, and liver problems are among the effects on children directly traced or linked to the use of this drug.

Research¹ has linked spina bifida, a brain, and spinal cord defect, to Depakote intake during pregnancy.

It is not advisable to take this medicine if you plan to get pregnant. However, you can’t just discontinue taking Depakote because the increased risk of relapse is common among mood stabilizers. Speak with your doctor about safely coming off Depakote.

Interactions with other drugs

Depakote might interact with common drugs like aspirin and certain carbapenem antibiotics such as ertapenem and meropenem. These antibiotics decrease the effectiveness of the drug, while aspirin, on the other hand, increases the effects of Depakote.

Depakote could increase the effects of anti-depressants such as amitriptyline and nortriptyline, and other anticonvulsants such as phenytoin, carbamazepine, and lamotrigine. 

On the other hand, Depakote might decrease the effectiveness of some mood stabilizers such as olanzapine and the antiepileptic drug oxcarbazepine.

Diazepam (Valium) may increase the effects of Depakote.

Allergy information

There are instances of Depakote causing severe allergic reactions. Some allergic reactions include rashes, while some develop blisters in the body. Others report sores in their mouth.

Severe allergic reactions (anaphylaxis) can cause symptoms including:

  • Swelling of the face, lips, tongue, or even throat

  • Trouble swallowing and breathing

Anaphylaxis is an emergency, and you should seek urgent medical care.

Clinical trial history²

Two studies found that Depakote was superior to placebo for treating acute mania in bipolar disorder.

Seven pediatric clinical trials tested Depakote, including one study in children with epilepsy. Most of the trials looked at safety and tolerability in pediatric patients. All found that the results were comparable to the safety levels in adults. 

Another trial³ compared the efficacy of Depakote to placebo for bipolar disorder in children and adults and assessed its safety. It showed no significant difference between the effects of Depakote and placebo for bipolar depression.

The trial results do not support using Depakote for children and adolescents with bipolar disorder, mania, or mixed states. Additional studies are needed to confirm or refute the results of this study.

Efficacy has still not been established for the treatment or prevention of migraines or mania.

Tips and advice for taking Depakote

  • Swallow Depakote ER whole, and never chew or crush them.

  • It is advisable to take it with food or after eating in cases of an upset stomach.

  • Depakote Sprinkle Capsules can be swallowed whole or sprinkled in your soft food (hence the name). If you sprinkle Depakote into food, you must swallow the food without chewing it, as this could impact how your body absorbs the drug. Check with your doctor or pharmacist if you have any questions.

  • Check for side effects such as sleepiness and dizziness. If you have those side effects, it’s best not to drive until they wear off.

  • Do not drink alcohol when taking this drug as it increases the risks of side effects.

  • Check your stool or vomit for undigested pills. If this happens, your body might not be absorbing the medicine properly.

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Disclaimer

Here at HealthMatch, we’ve done our best to ensure that the information provided in this article is helpful, up to date, and, most importantly, accurate.

However, we can’t replace the one-to-one advice of a qualified medical practitioner or outline all of the possible risks associated with this particular drug and your circumstances.

It is therefore important for you to note that the information contained in this article does not constitute professional medical or healthcare advice, diagnosis or recommendation of treatment and is not intended to, nor should be used to, replace professional medical advice. This article may not always be up to date and is not exhaustive of all of the risks and considerations relevant to this particular drug. In no circumstances should this article be relied upon without independent consideration and confirmation by a qualified medical practitioner.

Your doctor will be able to explain all possible uses, dosages, precautions, interactions with other drugs, and other potential adverse effects, and you should always talk to them about any kind of medication you are taking, thinking about taking or wanting to stop taking.

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