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Depakote
Depakote (divalproex sodium) is a medication used to treat various conditions, including seizures, bipolar disorder, and migraine prevention. It works by increasing the levels of a neurotransmitter called gamma-aminobutyric acid (GABA), which helps calm nerve activity in the brain. Depakote is available in multiple forms, including delayed-release and extended-release tablets, and is used for long-term management of these conditions.
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Frequently Asked Questions
How long does it take for Depakote to start working?
The effects of Depakote on mood stabilization and seizure control may take a few days to a few weeks to be fully noticeable. For migraines, it may take several weeks of consistent use to see a reduction in frequency.
Can Depakote cause weight gain?
Yes, weight gain is a common side effect of Depakote. Patients should monitor their weight and discuss any concerns with their healthcare provider.
What should I do if I miss a dose of Depakote?
Take the missed dose as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
Is Depakote safe to use during pregnancy?
Depakote is not recommended during pregnancy due to the high risk of birth defects. Women of childbearing age should use effective contraception and consult their healthcare provider about alternative treatments.
Can Depakote be used for long-term treatment?
Yes, Depakote is often used for long-term management of epilepsy, bipolar disorder, and migraine prevention. Regular monitoring by a healthcare provider is essential to ensure safe and effective use.
Comprehensive Drug Guide
How Does Depakote Work?
Depakote works by increasing the amount of GABA, a neurotransmitter that inhibits nerve transmission in the brain. This helps reduce seizure activity, stabilize mood in individuals with bipolar disorder, and prevent migraines by calming overactive nerve cells.
Common Dosages
- Delayed-release tablets: 125 mg, 250 mg, 500 mg
- Extended-release tablets: 250 mg, 500 mg
- Capsules and sprinkles: 125 mg
Typical Dosing
- For seizures: The dose is typically 15 mg/kg/day, with gradual increases until the desired effect is achieved.
- For bipolar disorder: The starting dose is usually 750 mg/day, divided into smaller doses.
- For migraine prevention: The usual dose is 500 to 1000 mg/day.
Typical Dosing
FDA Approved Indications
- Seizures (including epilepsy)
- Bipolar disorder (specifically for the treatment of manic episodes)
- Migraine prevention
Who Shouldn't Take Depakote?
- Known hypersensitivity to valproate, divalproex sodium, or any component of the formulation.
- Liver disease or significant liver dysfunction.
- Mitochondrial disorders, such as Alpers-Huttenlocher syndrome.
Advice From The Pharmacist
- Depakote should be taken with food to reduce the risk of gastrointestinal upset.
- It is important to have regular blood tests while taking Depakote, as it can affect liver function and blood cell counts.
- Do not stop taking Depakote suddenly without consulting your doctor, as this may lead to seizures or other serious side effects.
Side Effects of Depakote
Common Side Effects
- Nausea
- Drowsiness
- Dizziness
- Tremors
- Weight gain
Uncommon/Severe Side Effects
- Liver toxicity
- Pancreatitis
- Low platelet counts
- Severe allergic reactions
Risks and Warnings of Depakote
- Liver Toxicity: Depakote has been associated with serious liver damage, particularly in children under 2 years old and in individuals with pre-existing liver conditions. Liver function should be monitored regularly.
- Pancreatitis: Depakote can cause inflammation of the pancreas, which can be life-threatening. Patients should be monitored for symptoms like severe abdominal pain and vomiting.
- Pregnancy Risk: Depakote can cause serious birth defects when taken during pregnancy, especially in the first trimester. Women of childbearing age should discuss alternative treatments with their healthcare provider.
Interactions with Depakote
Common Drug Interactions
- Aspirin: Taking aspirin with Depakote can increase the risk of side effects due to increased drug levels.
- Warfarin: Depakote can increase the effects of blood thinners like warfarin, leading to a higher risk of bleeding.
- Antidepressants: Combining Depakote with certain antidepressants (e.g., SSRIs) may increase the risk of side effects, including serotonin syndrome.
Alternatives to Depakote
- Lamictal (lamotrigine): An anticonvulsant used for seizures and mood stabilization in bipolar disorder.
- Topamax (topiramate): Another anticonvulsant often used for seizures and migraine prevention.
- Lithium: A mood stabilizer commonly used for the treatment of bipolar disorder.
