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Depakote ER
Depakote ER (divalproex sodium extended-release) is an anticonvulsant and mood stabilizer used to treat seizure disorders, bipolar disorder, and to prevent migraine headaches. It works by increasing the levels of certain chemicals in the brain that help prevent seizures and stabilize mood. The extended-release formulation allows for once-daily dosing, providing consistent therapeutic levels throughout the day.
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Frequently Asked Questions
How long does it take for Depakote ER to start working?
For seizure control or mood stabilization, it may take several days to weeks to see full benefits. For migraine prevention, it may take a few weeks to notice a reduction in headache frequency.
Can I stop taking Depakote ER if I feel better?
Do not stop taking Depakote ER suddenly, as this can lead to withdrawal symptoms or a return of seizures. Always consult your healthcare provider before making any changes to your treatment plan.
Is Depakote ER safe to use during pregnancy?
No, Depakote ER carries a high risk of birth defects and developmental problems if taken during pregnancy. Women of childbearing potential should use effective contraception and discuss family planning with their healthcare provider.
What should I do if I miss a dose of Depakote ER?
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at once.
Can Depakote ER cause weight gain?
Yes, weight gain is a common side effect of Depakote ER. Maintaining a healthy diet and regular physical activity may help manage this effect.
Comprehensive Drug Guide
How Does Depakote ER Work?
Depakote ER works by increasing levels of gamma-aminobutyric acid (GABA), a neurotransmitter that helps calm nerve activity in the brain. This helps control seizures and stabilize mood in patients with bipolar disorder. It also helps prevent the onset of migraines by stabilizing electrical activity in the brain.
What is Depakote ER Used For?
- Seizure disorders (partial seizures, generalized seizures, and absence seizures)
- Bipolar disorder (specifically for the treatment of manic episodes)
- Migraine prevention
Common Dosages
Depakote ER is available by prescription in extended-release tablets. It is not classified as a controlled substance.
- 250 mg extended-release tablets
- 500 mg extended-release tablets
Typical Dosing
FDA Approved Indications
- For seizure disorders, the typical starting dose is 500 mg to 1000 mg daily, with adjustments based on clinical response and tolerance.
- For bipolar disorder, the recommended dose is 1000 mg daily, though it may be adjusted according to the patient's needs.
- For migraine prevention, the initial dose is 500 mg once daily, which may be increased to 1000 mg daily.
Who Shouldn't Take Depakote ER?
Depakote ER should not be used in individuals with:
- Liver disease
- Mitochondrial disorders
- Known hypersensitivity to divalproex sodium or its components
- Urea cycle disorders
Advice From The Pharmacist
- Take Depakote ER exactly as prescribed, with or without food, and do not crush or chew the tablets as this can interfere with the extended-release formulation.
- You may need to have regular blood tests to monitor liver function and drug levels while taking Depakote ER, as it can affect liver health.
- Avoid alcohol while taking Depakote ER, as it can increase the risk of liver damage and affect the medication’s effectiveness.
Side Effects of Depakote ER
Common Side Effects
- Nausea
- Drowsiness
- Dizziness
- Tremors
- Weight gain
Uncommon/Severe Side Effects
- Liver toxicity
- Pancreatitis
- Thrombocytopenia (low platelet count)
- Severe allergic reactions (e.g., rash, swelling, difficulty breathing)
Risks and Warnings of Depakote ER
Liver Toxicity: Depakote ER can cause severe liver damage, particularly in children under 2 years of age and patients with pre-existing liver conditions. Liver function should be monitored regularly.
Pancreatitis: This medication can cause life-threatening pancreatitis. Report any sudden abdominal pain, nausea, or vomiting to your healthcare provider immediately.
Teratogenicity: Depakote ER is associated with a high risk of birth defects if taken during pregnancy. Women of childbearing age should use effective contraception and discuss pregnancy risks with their healthcare provider.
Interactions with Depakote ER
Common Drug Interactions
- Blood thinners (e.g., warfarin): Depakote ER can increase the risk of bleeding.
- Other anticonvulsants: Concurrent use with other seizure medications may alter drug levels, requiring dosage adjustments.
- Antidepressants: Some antidepressants may interact with Depakote ER and affect its efficacy or increase the risk of side effects.
Alternatives to Depakote ER
- Lamotrigine: Another anticonvulsant used for seizure disorders and bipolar disorder, often considered for patients who do not tolerate Depakote ER.
- Topiramate: A medication used for seizure control and migraine prevention.
- Lithium: Commonly used for mood stabilization in bipolar disorder.
- Carbamazepine: Another anticonvulsant and mood stabilizer used for bipolar disorder and epilepsy.
