Mental Health Treating joint pain from Depakote

[Mmp85]

To start with I'm very happy with my Depakote. There were a few kinks at first because the dose was too high and it left me more than just zombie-fied, it knocked me cold and when I was awake I was barely functioning and high as a kite. Granted I was a very pleasant person to be around because I went on the Depakote because I was getting manic episodes and not the "fun" kind, the tempermental kind where I was irritable and yelling at everybody.
Anyway it's definitely been the best choice of mood stabilizers for when mixed with my other medication, seroquel is something I'll never try again, I could barely get out of bed on that stuff and my doctor says he doesn't consider me a candidate for lithium.
On the lower dose the only side effect that I find really hard to deal with is joint pain. It took me awhile to make the connection. I had actually convinced myself I had developed arthritis at 30. What I'm wondering is if since its a side effect of medication and not just ordinary pain should I be treating it differently than I would normal pain?

 

[paranoid android]

Yeah unfortunately joint pain is a common side effect of Valproate. It can range from being very minor and hardly noticeable to feeling like you need to put oil on your joints because they are so fucking sore stiff. Oddly enough even though i do have Arthritis Epival/depakote never made it worse but then again it didn't do anything positive for me either. As far as i know doctors treat it the same way they treat joint pain caused by anything else which is with NSAIDS. I find Ibuprofen to work better then anything you need a script to get actually. I have tried Ibuprofen, Naproxen (made me puke after just 1 dose), Ketoprofen (sort of helped but not as much as Ibuprofen), Ketorolac trade name Toradol (made me puke and didn't do anything for pain), Celecoxib (didn't do anything) and of course Aspirin which sort of helps but not as much as Ibuprofen for joint pain. As you probably know you absolutely cannot take Aspirin while on Depakote or any other Valproate as it can cause blood levels of Valproate to go toxic. Oh one i forgot to mention is Voltaren gel which is just the NSAID Voltaren applied topically. I find this to work fantastic for joint pain but sadly it's not covered under my insurance and is rather pricey. That would be one definitely work trying in my opinion.

Have you spoken to your doctor about this? If you haven't i would suggest doing so as they would know your medical history better then anybody here and know if NSAIDs are a suitable treatment for you. Good luck to you as i know exactly how much of a absolute bitch joint pain is. Some days i swear i feel like rusty the fuckin tin man my joint pain feels so bad.

 

[Mmp85]

Yeah it's not very bad right now because I'm building up to my full dose because I was off it for awhile just because my schedule was unpredictable and it was hard to maintain routine with all my medication. So I'm cutting my 500 mg pills in half for about a week and then I'll go up to the 500 mg which is what my prescription is at currently down from 1500 mg which was way too high for me and I wasn't able to stay at for more than a few days. If 500 mgs ends up not feeling like enough I know I can go as high as 1,000.
Hopefully the pain won't be as bad at 500 mg as it was when I was at 1,000 mg and trying to get to 1,500 mg. I remember trying to kneel or squat and then not being able to stand back up. I was in panic mode thinking I had a debilitating form of arthritis or something like fibromyalga because I hurt all over, I was even looking at disability insurance because I'm a waitress and on my feet all day. It was actually a relief that it was a drug side effect.
When it got bad the last time I wore those stretchy elastic ankle and knee braces and used a heating pad at home and wore those heating patches you stick on.
My knees gave me the most trouble probably because I put more pressure on them.

 

[paranoid android]

^ I feel bad for waitresses honestly because they are on their feet the entire fucking shift and get treated like shit by the cook. A very good friend of mine has done alot of waitressing and after hearing the shit she has to put up with i can't not tip them.

So your on 250mg's of Depakote if i am doing the math right? That's not a very high dose at all. I think i ended up on about 1000mg's and then called it quits as it just didn't help me. I was on that along with 400mg's of Seroquel and 6mg's of Clonazepam to help my anxiety, Mania and Trigeminal Neuralgia as well. The Seroquel and Clonazepam where the only things keeping me from losing the plot because i didn't notice 1 bit of difference when i stopped taking the Divalproex.

The downside to Divalproex is that it's not a actual mood stabilizer as unlike Lithium or Lamotrigine or even some anti-psychotics such as Seroquel or Zyprexa it doesn't do anything at all for the depression part of Bipolar disorder. It's actually classified as a Anti-Manic drug just like Carbamazepine which is another anti-convulsant commonly used in treating mania and also mixed states i do believe. I used to get mixed states alot unfortunately and they are fucking torture. Actually i would take physical torture over them anyday. I haven't had one now in years though thank fuck.

 

[Mmp85]

I should be taking 500 mg but I didn't want to all at once, I'll probably eventually take 1,000 mg.
I take lamictal as well and Prozac and Effexor. I probably don't need the Prozac mixed in there anymore but I've been on it for so long that I think he just never bothered to take me off. I'm much more prone to mania than depression which is why I've really liked the depakote.

 

[Cotcha Yankinov]

The skeleton/joint issues from depakote seem to be via a problem with development of bone cells called osteocytes and osteoblasts, I don't think that NSAIDs will get at the root of this degeneration but they might help with the symptoms and inflammation. One study put the number of people experiencing severe bone mineral density issues from being on these anti epileptic drugs long term at 50%.

I have to give a warning here, there are some truly horrible long term effects with Valproate, especially the spinal side effects. I wouldn't want to be on it for long. There are better options, like Eslicarbazepine Acetate (trade name Aptiom) that shouldn't be hard on your joints but should still help with your mood.