Depakote experiences

[Missykins]

Howdy all,

I have bipolar disorder (who doesn't) and currently take 1200 mg of lithium, divided into two equal doses, am and pm. Lithium gives me a horrible tremor. It used to be somewhat well-controlled by taking 60 mg of propranolol at night.

But, about two years ago, I developed debilitating vertigo. I couldn't drive, work, or leave the house because I never knew when it would happen. It took several months to find the right neurologist and the right medication. I take verapamil for the vertigo, which is a calcium channel blocker, and because of that, I can no longer take the propranolol because it drops my heart rate and blood pressure too low. Also, verapamil has a well-documented effect upon lithium by potentiating its adverse effects, especially anything neurologic like a tremor. Therefore, my lithium tremor is out of control, making it nearly impossible to do my job. I can't even get my contacts in most days.


My psych has suggested that we change my lithium to a controlled-release formula to be taken only at night to avoid the peaks associated with immediate-release formula. We tapered to 900 mg but I've yet to appreciate a difference.

My doctor is now suggesting we drop the lithium all together, and switch to depakote. Has anyone had any experience with this drug? Any bad side effects? I hear that it's supposed to be sedating which means I'll probably have to drop the Seroquel unless I want to become a zombie. There is also an FDA "black-box warning" about combining it with drugs used to treat seizures, like Lamictal, which I also take.

I know this is a long post. Any and all replies are appreciated.!

 

[paranoid android]

I was put on depakote called epival here in Canada as the first anti-manic aka mood stabilizer i tried for bipolar. I was put on it to add to the seroquel i was already taking.

I didnt get any bad side effects from it but it did not seem to help either. I ended up on about 750mg's a day which is not much at all maybe thats why it didnt help. It does nothing to help the depression side of bipolar unfortunatly either.

It can be pretty hard on the liver and thats why you need regular blood tests. It can also interact badly with lamictal which is the mood stabilizer switched to. It raises the level of lamictal in your blodd and thus can cause bad skin reactions and everything else.

 

[Missykins]

^^Paranoid, did you notice any sedation with using Seroquel and Depakote together?


Yes, I've heard that Depakote really does nothing to treat bipolar depression.

One thing I have noticed is that my tremor is nearly always worse in the morning, and nearly completely resolved by evening. I'm going to switch it around and take the lithium in the morning and the verapamil at night and see what happens.

 

[Lolie]

I take Epilim (sodium valproate) and Seroquel. The Epilim alone doesn't have a sedating effect on me. It's a really common combination here because it's cheap and it's effective for a lot of people.

Not sure why your doc would want to have you on two anti-convulsants (Depakote +Lamactil), but it is common to use Depakote has the primary mood stabiliser or to potentiate anti-psychotics.

You'll probably have to have occasional blood tests while you're on the Depakote, but not to the same extent as with Lithium. Weight gain is a real possibility on the combination of Depakote and Seroquel. Seroquel on its own can drop blood pressure and Depakote potentiates Seroquel so that might be an issue for you - I get occasional bouts of postural hypotension from the medication, especially if I'm not well hydrated.

I don't feel like the sodium valproate on its own did much for me. I suspect that it's the Seroquel which is having the positive effect in my case and sometimes I feel like ditching the Epilim because I'd rather not be risking its downside for no benefit - but Seroquel can't be prescribed as a monotherapy for bipolar disorder for longer than 6 months, it can only be prescribed for maintenance in conjunction with Lithium or sodium valproate.

Forgot to mention that I developed photosensitivity from the sodium valproate. If I go out in the sun, I develop a rash on the exposed skin.

 

[paranoid android]

I never noticed any additive sedation caused by the depakote. I got just as drowsy from the seroquel alone. I didnt gain weight at all either like some people do. Depakote/epival can be a real bad weight gainer but then again alot of anti-psychotics are too.

The seroquel did more to help my mood then the epival did im pretty sure.

 

[Missykins]

Thanks for advice. A lot of people say that Seroquel monotherapy is usually sufficient. I've never tried it alone. Lamictal as stand-alone treatment also did not help me. Lithium has always been my saving grace--I respond quickly, especially if I am feeling suicidal. Going of the verapamil isn't an option because I can't risk another vertigo episode while I'm driving like before. Nearly all of these meds cause birth defects and are excreted in breast milk. I'd like to have a family someday, so that sucks.