109 thoughts on “Bipolar Medication Spotlight: Depakote (Valproic Acid)

  • August 1, 2008 at 7:16 am

    Depakote was a real lifesaver when my wife was first hospitalized with a severe manic episode. It brought her mania down fairly quickly.

    Unfortunately, it caused some fairly significant weight gain, and she had to stop taking it. In other words, it was useful for short-term treatment of acute mania but wasn’t something she could stay on long-term.

    I read a recent press release on a new delayed-release gelcap form of valproic acid called Stavzor™. You can read the press release for yourself, “Banner Pharmacaps Receives FDA Approval for Valproic Acid Delayed Release Softgel Capsules.”

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  • August 26, 2008 at 8:25 pm

    My 16 yr old daughter was just prescribed Depakote by a Dr for hyperactivity, test taking and concentration problems as well as sleeplessness. Dr says its a form of Bi-polar although she does not have mood swings nor has she had any behavior or social problems ever. Concerned this is a bad diagnoses. Has anyone ever heard of this drug used in teens who are not in some sort of trouble or distress?

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  • August 29, 2008 at 9:45 am

    Hi Joyce –

    I would be concerned about the use of Depakote to target those symptoms without a very strong and well supported diagnosis of bipolar disorder – with manic and/or depressed episodes. If the problems are present chronically and not occuring in episodic fashion that would certainly be a red flag to me that the diagnosis might be off target. If she has not had a manic or depressed period at all – then the diagnosis is also hard to support.

    Of course I have not done a full evaluation on your daughter and so can make no comment about what her diagnosis is. However, given the lack of stronger diagnostic evidence for the choice of medication I would strongly recommend getting a second opinion before deciding on what medications to use or if medications are indicated at all.

    Candida Fink MD

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  • September 9, 2008 at 8:45 pm

    I had been taking Depakote for close to eight years at a dose of 250mg and was stable. After having a great loss in my life and having to change to a new doctor. My doctor increased the dose to 825mg. I started to have symptoms of stomach pain, not wanting to eat, not going to the bathroom, feeling tired, and more. The doctor thinks I need more but I am concerned that it is the Depakote because I have always had drug sensitivities. My question is does this sound dangerous and how quickly can I get off of this dose back to my old dose of 250mg?

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  • September 11, 2008 at 4:21 pm

    Hi, Dot-

    A normal starting dose of Depakote is between 750mg and 1500mg and is usually ramped up to an effective range of between 1000mg and 2000mg, so being stable on 250mg is kind of surprising. Even at 825mg you’re on the low end of the starting range.

    In most cases, doctors shoot for a blood level (concentration of Depakote in the blood) of 50 – 125 (micrograms/mL) as the “therapeutic” level – the level at which the medication is safe and effective, so not everyone will take the same dose. Your doctor has probably ordered blood tests and is monitoring the blood level to see where you’re at.

    I’m no doctor, but I wonder whether the symptoms you’re experiencing are side effects of the Depakote or symptoms of depression that can set in once your mania is under control. It’s best to discuss the symptoms with your doctor.

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    • August 30, 2012 at 10:24 pm

      Hi Joe,Do you take depakote of know someone who does and had hair loss? That is one side effect that I am concerned about. When it happens and how much do you loose. Right now I am on 1,000mgs. Thanks,PBEE

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  • September 17, 2008 at 11:26 am

    I have been trying to learn more about why my husband behaves the way he does. I know that I am not qualified to diagnose whatever the issue is. I guess I am just looking for some clues, some kind of starting point, because we need help. Based on different things I have read I believe my husband may have bipolar disorder. He has epilepsy so I was trying to see if his behavior could be linked to that or a side effect of his med depakote. My search lead me here and I was suprised to see the same med he takes for epilepsy is used to treat bipolar disorder. I am guessing there is a connection maybe in that part of the brain. He has been taking the depakote since he was 12 and though he does seem to show signs of mania it is definitely not as intense as his depressive behavior, so maybe it has been helping. Again I know we need professional help. I am just trying to arm myself with info as I search for a way to approach him. He is extremely sensitive and if you don’t say things just right he explodes or totally withdrawls. Our talks about even the simplest subjects have become awkward because I feel like I am walking on eggshells careful to not say the wrong thing, he has picked up on this and has become annoyed with my new timid behavior. I really want to understand what is going on in my husband’s mind, he seems miserable too and I don’t want us to live our lives this way.

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  • September 19, 2008 at 10:39 am

    Boots – Much of what you wrote applies to me exactly – my husband was just diagnosed 2 weeks ago with bipolar 11 – The lithium he started to take has not yet started to work on him – He is impossible to talk to -he is hostile – angry – finds me the “stupid one” other the smallest issue – argues with me all the time – and drives the car like a maniac when he picks me up after work – I feel like walking away from him completely – but I do love him – although I DO NOT like him most of the time – I hate going home after work and I hate weekends being around this miserable angry man – I have no one to talk to as he does not want our children or anyone to know about this – He seems ov the verge of a complete breakdown – He is the one who is sick but I am also suffering – although I can’t even tell him that – I feel for you – I know exactly what you are going through!!!

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    • July 1, 2013 at 4:38 pm

      Nancy Depakote is by far better than lithium! Lithium can cause moods and irritability. My other half has been stable on Depakote for 12years now and never looked back. (It was the same as you describe on Lithium.) You just have to remind the doctor to do a bloodtests every 4 months with Depakote. I have been through the same and totally understand what you are going through! Good luck just get the doctor to change meds to Depakote. Sometimes your other half may think he doesnt need meds,then he may stop taking them so you need to check he regularly takes the right dose but don’t let him know you checking or he will think you don’t trust Him. Thats part of the illness. Things they say sometimes they don’t mean remember its the illness. Good Luck

      Reply
  • September 28, 2008 at 8:37 am

    husband has successfully been on depakote. has recently been diagnosed with renal failure and put on phoslo which is a bindery drug..but also needed. he takes depakote ER and now levels are very low…20-30 range when used to be at 75ish…. know it has to be the phoslo that is binding up the depakote? what can we do? which is more essential the phoslo or the depakote? doctor will not go back to regular depakote because state too much confusion around the two….what can we do?????

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  • September 29, 2008 at 3:14 pm

    Wife –

    Have your psychiatrist and renal docs had an actual conversation? I suspect there is a way to help your husband get his levels back to therapeutic but it will take some coordination of care between the specialists. Perhaps the psychiatrist feels your husband will be stable on a lower blood level of depakote – you may want to ask her what she is thinking about that. “Too much confusion” isn’t a reason for not doing something – it is a reason to go out and get more information and find different ways to solve the problem.

    Candida Fink MD

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  • November 27, 2008 at 1:58 pm

    My 19 year old son has been taking 1125 mg. depakote for bipolar disorder, his mood swings were stable but are back. I think his depakote levels are too low. Does anyone know the recommend dosage of depakote for maintenance purposes? He is 180 lb. and 6’2″ he has psych appointments next week, but I’m just curious about dosage requirements. Also, has phobia of blood tests, but did take one yesterday to check his depakote levels.
    Any info. is appreciated.
    Thank you.

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  • November 29, 2008 at 8:08 am

    Hi, Kitty

    The recommended starting dose is between 750 and 1500 mg daily, while the usual effective dose is between 1000 and 2000 mg daily. More importantly, however, is the blood level at which Depakote is effective, which is 50 – 125 (micrograms/mL).

    The reason why the blood level is more important is because two people can take identical doses and have very different blood levels depending on other factors, such as fluid intake and exercise.

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  • January 1, 2009 at 12:00 am

    trying to find the correct dosage for my 17 year old teen age son… right now he is on 3 500 mg tabs a day.

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  • January 2, 2009 at 2:03 am

    My husband is on depakote and we are trying to conceive. Does depakote damage sperm and therefore cause birth defects in the children of men who are on depakote? I think I read somewhere that it changes the chromosomes in sperms.

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  • January 13, 2009 at 11:44 am

    LaRue
    There has been some data in mice suggesting some changes in sperm in male mice taking depakote. There really isn’t good data in humans. I would encourage you to discuss this with your GYN doc – and consider meeting with a genetic counselor to get more detailed answers on this question.

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  • January 13, 2009 at 11:47 am

    Toi –
    The right dose of Depakote varies tremendously between indiviudals so there is not one “correct” dose. Blood levels help doctors determine dosage range, but the doc will also be looking at age, size, clinical response and side effects in making decisions regarding dose changes.
    I encourage you and your son to ask your prescriber how they are making the dosing decisions and to include you in their thinking as they go along.

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  • January 15, 2009 at 2:13 pm

    I have been diagnosed with bipolar disorder for five years (since I was 19 yrs. old) and I have been on valproic acid (750 mg a day) for the entire time I have been diagnosed. Since then I have gained a lot of weight but I don’t think it is because of the medication but after doing research I keep hearing otherwise. I was quite thin before I was diagnosed and I started gaining weight before I even took the medication and was diagnosed. I never tried to lose the weight or eat better and as a result I am way over the weight I should be. For the first time in the five years since the weight gain I have developed a much healthier eating plan and for the first time in my life I’m doing regular cardiovascular excercise (a combination of speed walking and cycling on an excercise bike). I’ve been doing this for two months and I’ve lost 20 lbs. and I’m not starving myself or taking any weight loss pills. And I take valproic acid and temazapam every night. So what’s the deal? Why are people on this medication being discouraged by being told they cannot lose weight on this medication? I’m defying that statement as we speak and mentally speaking I’m not in a state of mania or depression. I’m feeling fine.

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    • July 23, 2014 at 2:01 am

      That’s great dear! But it’s most likely because you are younger and your metabolism is still good 🙂 The rest of us middle agers have the weight problem with the pills and them can’t get it off despite our best efforts. I cut back calories and started going to the gym and GAINED weight :p

      Reply
  • January 18, 2009 at 11:02 pm

    I have been on Depakote for almost 4 weeks now and have not noticed any major breakthroughs with my bipolar disorder. I still have suicidal thoughts for a few hours only to be invincible right after…My doctor is all about controlling the mania but what happens when Im depressed again and do something stupid and get hospitalized again?…by the way im an addict so this comment may be null and void…Thank you

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  • February 3, 2009 at 11:59 pm

    My husband has had abrain injury. Prior to the accident he was very angry with me and really showing signs that he might be bipolar. This had been a cycle with him very angry and rageful about twice a year. Now since the accident he had a bout of very seroius depression and now about 1 year later he is enraged. With me mostly, the kids and our family. His new psychiatrist has prescribed Depakote. I really am praying this is the help we need. I walk on eggshells, and am not allowed to speak because it annoys him. We live parallel lives I hate it. He has told me he hates me and called me every horrible name you can think of. Does this sound like it could be bipolar disorder/or just a result of brain injury? I want Depakote to take away the anger and allow him to be approachable again. Am I unrealistic?

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  • February 6, 2009 at 4:56 pm

    I was diagnosed 13 years ago, Im way more manic than depressive but that has changed over the years. I was treated with Epival for almost 5 years when I began having vivid dreams that lead me to panic attacks and weird phobias. This also caused fertility problems because I began taking it at a very early age (17). Some of them are reversible but my doctor doesn’t want me taking any hormones and stuff like that. I also gained a lot of weight. To help, he added Lamictal and that seemed to work but weight issues got worse. I stopped taking everything for almost 3 years; im rebellious. Miraculously I didnt get better nor worse but was eventually taken back to Valproic Acid. I’m now on Epival, Lamictal and recently started taking Seroquel. Mania is slowly getting worse; Im confused and erratic as well.

    Long story short: Valproic acid may work but I truly HATE it. HATE IT. Side effects are not so side, are recurrent and normal. Hate it because I wont be able to get pregnant ever and it makes me sad that I might be stuck with this forever. HATE IT.
    Any options I might have? Thanks

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  • March 10, 2009 at 5:28 pm

    our son has been on depakote for 1yr.started out with 1000mg nine mos into taking it the pdoc reduced him to once a day 750mg along with 12mg of concerta….his blood workup levels came back at 8….could someone please tell me is this a clue that he IS NOT taking the depakote? we have asked him and he says he is, the pdoc is having him redo the blood workup….could someone tell me where i can find info on the blood levels when using depokate…thank you for your help

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  • March 11, 2009 at 1:13 pm

    hi guys Ive been on 50mgs paxil 250mgs seroquel and up to last week 500mgs depokote ive been out of work 6 mths i started to cut back seroquel from 250mgs to 225 mgs i started to feel more alert and muscle aches doc wants to up the depokote but i told him it will make me feel depressed and sur enough it did i just upped it to 250mgs to 750mgs and i feel more agitated mood swings and at times more depressed so Is this common went you first go on it and if so what are the techniques to minimize this? btw back up to 250mgs on seroquel

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  • March 19, 2009 at 3:41 pm

    I began taking Depakote and Wellbutrin in 1999. I’ve been successfully treated with this combination for a decade. I am mania free, but I do still suffer from bouts of depression or inappropriate mood (crying for no reason) occasionally. The most troubling side effect for me has been weight gain. Prior to my treatment I weighed 145-150 lbs. I am now 190 lbs. I exercise regularly, 3-6 times per week for 60-120 minutes a session. I am reluctant to change medicines because Depakote is working so well for me, but I am concerned that this excess weight will be a problem in the long term. My parents suffer from high blood pressure, high cholesterol and diabetes. Lithium, Neurontin and Zyprexa were not effective for me. What other options do I have? My PA is reluctant to make a change since I am having therapeutic success on these meds.

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  • June 16, 2009 at 7:12 pm

    Does anyone know if this new form of valproic acid is better in its side effect profile then those big pink pills I took yrs ago with a 30lb weight gain I am currently taking 1000mgs just increased from 750mgs Ive been out of work for 9 mths I know I need depokote but hate weight gain I have so far gained about 7lbs Id like to hear from anyone on Stavzor and how it has affected their weight

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  • July 23, 2009 at 10:28 pm

    6 years ago i was diagnosed with bipolar disorder and had to take meds after leaving college. at the time i took wellbutrin, risperidol, and depakote. i have been off the meds for 2 years and was prescribed 500 mg every other day bc my cycles were starting to increase in duration and severity. is this common to only have one med now? i no longer have the same psychiatrist and this is what my regular doc suggested, which he was my reg doc during my original diagnosis. thanks for any advice.

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