* Depakote is a brand (trade) name for divalproex sodium. Depakote
may be used to treat certain types of seizure, to reduce mania in
people with bipolar disorder, and as a preventive treatment for
migraines.
* Experts are not exactly sure how Depakote works although they
suspect its activity is related to increased brain concentrations
of gamma-aminobutyric acid (GABA) - a neurotransmitter in the brain
that calms nervous activity.
* Depakote belongs to the class of medicines known as antiepileptics
(AEDs) or anticonvulsants.
Upsides
* May be used either alone or in combination with other
antiepileptics for the treatment of complex partial seizures,
absence seizures, and for several other types of seizure.
* May be used to control manic episodes in people with bipolar
disorder.
* May be effective for the prevention of migraine headaches in some
people.
* Depakote is available as a generic under the name divalproex (may
also be called divalproex sodium).
Downsides
If you are between the ages of 18 and 60, take no other medication or
have no other medical conditions, side effects you are more likely to
experience include:
* Abdominal pain, nausea, diarrhea, constipation, dizziness,
drowsiness, weakness, and weight loss are the most commonly
reported side effects. May also cause bleeding gums, bloating or
swelling, cough, a tremor, hair loss, ataxia, nystagmus, skin rash
and thinking difficulties.
* Side effects such as an increase in liver enzymes and
thrombocytopenia (a decrease in platelet numbers in the blood) are
more prevalent at higher dosages.
* Depakote may not be suitable for everyone including those with
depression or other mental illness, HIV or cytomegalovirus
infection, liver disease, mitochondrial disorders, or urea cycle
disorders. Elderly people may be more sensitive to side effects
including drowsiness.
* May cause fatal liver failure; the risk is greatest in children
aged less than two and people with underlying conditions (such as
mitochondrial disorders, preexisting liver disease, and a urea
cycle disorder).
* Depakote is not recommended for migraine prophylaxis in pregnant
women. If you are using Depakote to treat epilepsy of manic
episodes use effective birth control and speak to your doctor
before choosing to become pregnant. Depakote can cause birth
defects in unborn children.
* Cases of life-threatening pancreatitis have been reported in both
children and adults receiving valproate short-term or long-term;
symptoms include abdominal pain, nausea, vomiting and weight loss.
* As with other antiepileptics, Depakote may increase the risk of
suicidal thoughts or behavior particularly in young adults under
the age of 24. Monitor for worsening mood.
* May interact with a number of different medicines including
aspirin, other antiepileptics, carbapenem antibiotics, felbamate,
and rifampin.
Notes: In general, seniors or children, people with certain medical
conditions (such as liver or kidney problems, heart disease, diabetes,
seizures) or people who take other medications are more at risk of
developing a wider range of side effects. For a complete list of all
side effects, [84]click here.
Bottom Line
Depakote may be used in the treatment of epilepsy, mania, and to
prevent migraines; however, people taking Depakote should be monitored
for potentially fatal side effects such as liver failure and
pancreatitis and it should not be used in women of childbearing age
unless benefits outweigh risks and reliable contraception is used.
Tips
* Swallow Depakote tablets whole, do not crush or chew. Depakote
sprinkle capsules may be opened and the medicine sprinkled onto a
spoonful of pudding or applesauce to make swallowing easier.
* Dosage depends on a number of patient factors including age,
medical condition for which Depakote is prescribed, sensitivity to
side effects, the presence of dehydration and nutritional status.
* Always take Depakote with plenty of water and maintain good
hydration throughout the day.
* If you experience stomach upset while taking Depakote, try taking
with food or ask your doctor if you can titrate your dosage more
slowly.
* May cause drowsiness and affect your ability to drive or operate
machinery. Avoid alcohol
* Be alert for changes in behavior including agitation, depressed
mood, and suicide-related events and seek medical advice if changes
are apparent.
* Always take Depakote exactly as prescribed. Never take too much
Depakote or stop suddenly without your doctor's advice. Symptoms of
overdosage of Depakote include changes in consciousness, fainting,
and slow or irregular heartbeat.
* Contact your doctor urgently if you experience stomach pain that
spreads to your back, nausea and vomiting, dark urine, facial
swelling, loss of appetite, or yellowing of the skin or eyes. Also
contact your doctor if you experience any mood changes, unusual
bruising or bleeding, flu-like symptoms, severe skin reactions, or
worsening of your symptoms.
* Blood tests may be needed to monitor effects of Depakote.
* Always tell your dentist or healthcare provider that you take
Depakote. Wearing a medical alert tag is a good idea.
* Avoid excessive sunlight exposure or tanning beds as Depakote may
make you burn more easily. Wear sunblock and protective clothing
when outdoors.
Response and Effectiveness
* The time it takes for Depakote to reach its peak effects depends on
the formulation used. Tablets take 4 hours to reach a peak,
Depakote sprinkles take just over three. Food can delay the
absorption of Depakote (food has a more significant effect on the
tablets compared with the sprinkles).
* It may take several weeks of regular dosing before an effect on
mood or seizure frequency is reported.
References
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