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Doctors' Answers to "Frequently Asked Questions" - Depakote

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 05/30/2000]
Question: If you are taken off Depakote, does the hair you may have loss due to the medication come back or is it permanent?

Answer: Usually comes back.

[posted 02/29/2000]
Question: A child psychologist in our area recently made a comment on a T.V. special that Depakote has been shown to provoke bursts of anger in some patients taking that medication. I am wondering if you know of any documentation to back up that statement.

Answer: There are reports of this, I do not have title and verse available. You can obtain this from the scientific department of Abbott 800-255-5162

[posted 01/31/2000]
Question: I work with an individual with developmental disabilities who is diagnosed with seizure disorder and bi-polar. My question is relating to the Depakote which she takes. I have read that Depakote can cause interference with thyroid function tests but have not been able to find any information as how it can affect the test. The individual I work with is also on Synthroid and I am curious if she may be on this medication and may not really need it? Do you have any information?

Answer: I don't know of any interaction between Depakote and the thyroid. There is one sentence in the precautions of the PDR that notes that there are reports of changes in the thyroid test, but I have not seen this problem.

[posted 11/19/1999]
Question: In the last 3 years I've had at least 1 and possibly 3 seizures.
My doctor prescribed Depakote. After I read the side effects,
I'm wondering if the side effects put me higher at risk for
something bad compared with the limited possiblitiy of me having
another seizure. Also they've only ever occured while I live in
Utah. I've lived in 4 other cities across the country in the last
3 years.
you think?

Answer: There arer potential toxicities. However, these can be monitored easily and there don't seem to be severe long term problems. Try the drug and see how it moderates your functional ability. The major problem is feeling drunk all the time. Neurontin would be less toxic and might be an answer depending on your EEG. But, the place you live is unlikely to have much bearing on the frequency of your seizures. Seizures are potentially life threatening, so need to be suppressed.

[posted 08/17/1999]
Question: I have been taking Depakote 250 mg twice daily since 9/97 and Remeron 7.5 mg since 1/98. In April 1998 I began experiencing stomach problems ( first nausea, indigestion) and now chronic pain and diarrhea ). I have gone through series of tests which have all been normal. Doctor does not think it's the medication since I just started having symptoms in April. Now, Doctor thinks it's IBS. I have never had stomach problems in my life. Could the medications I'm taking suddenly start having side affects and be causing my IBS symptoms?

Answer: Wouldn't expect them to, but check the Depakote levels to ensure that they are not higher than usual.

Depakote for Schizophrenia Treatment [posted 10/15/98]
Question: I am diagnosed with schizophrenia and take trilafon and olanzapine. I also take effexor and depakote; In trying to come off the depakote I had a very bad psychological reaction. In current medical practice is it unusual for a paranoid schizophrenic to require depakote or do I possibly fall within a different diagnostic classification? In addition, I also have marked tremors of the neck, head, and hands for which I am prescribed primidone, and the primidone has an additional positive effect on my mood.

Answer: Depakote has been used in many different medical syndromes in the past couple of years based on its relatively unique activity. While it is not approved for the treatment of schizophrenia by the FDA, it has been used in treatment with mixed success.

Depakote & Herbal Pill [posted 10/13/98]
Question:Is Depakote or Wellbutrin, mao inhibitors? I have also been taking Metabolife. (A new diet/energy natural herbal pill.) It is mostly for energy before a work out. Is this o.k.?

Answer: Neither is an mao inhibitor. There should be no problem with metabolife.

Depakote & Marijuana [posted 10/8/98]
Question:Are you aware of any contraindications between depakote (used to treat manic depression) and the use of marijuana? Can the combination be life-threatening? Can it interfere with the action of the depakote?

Answer: Out of my league, but, I'd ask the company- Abbott 800-633-9110.

Depakote & Ephreda Use [posted 10/2/98]
Question: I am taking Depakote for migraines and wish to begin taking Starlight,International, which is a diet supplement (nautral herbal) containing ephreda. I need to know if there are any negative interactions between Depakote and ephreda. I am, otherwise, in good health. Thanks!

Answer: None that I am aware of.

Liver Problems from Depakote [posted 7/23/98]
Question: How risky to the liver is depakote? Is there a certain dosage level that causes a jump in the risk? How much of a factor is aspirin? Does it totally need to be stopped for depakote? Does taking a cholesterol drug affect depakote and the liver? (one on the statins)

Answer: Depakote can cause liver toxicity in some patients for unclear reasons even if in the normal range. However, in general it is dose dependent. Aspirin does not appear to be a factor in this problem. As to the interaction between depakote and the statins, there is no clear evidence here, you'll need to monitor liver functions a little more closely.

Depakote Side Effects [posted 7/16/98]
Question: Has there been any bad reactions to this drug? I am taking this drug for bi-polar disorder.

Answer: Depakote has been used for a while, mainly for seizures, but also for other conditions. Side effects include headache, asthenia, decreased appetite, nausea, somnolence, body aches, vertigo, double vision, tremor, and hair loss. It depends a lot on the drug levels of the Depakote, but side effects are very common with this drug.

Depakote and Pregnancy [posted 7/16/98]
Question: Can you give me some information about the effects on a fetus if depakote is taken during first 3 weeks of pregnancy?

Answer: This study has not been done and will not be for ethical reasons. Studies in bacteria and mice haven't shown any particular worrisome effects.

Depakote and Effexor
Question: I am a bipolar who is currently taking Effexor and Depakote. Should I avoid prolonged exposure to sunshine and generally hot summertime conditions? That is, more so than a person who is not on these medications?

Answer: Depakote has been implicated in causing discoid lupus. This would involve sun sensitivity. Otherwise neither is a big risk.

Question: What is the complete list of side effects for Depakote?

Answer: Depakote(divalproex sodium) is an anti-seizure drug which has been available about 10 years. Side effects include liver toxicity (some deaths, especially small children), low platelet counts, nausea, sleepiness, vertigo, vomiting, abdominal pain, decreased appetite and rash. These are the common side effects. The others have been listed on rare occasions. There is a low list of minor side effects available in the Physicians Desk Reference, which is available in any book store or library.

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