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Re: Does Depakote cause depression?

Posted by Ted on October 2, 2000, at 18:06:17

In reply to Re: Does Depakote cause depression?, posted by SLS on September 27, 2000, at 21:55:29

I have been on Depakote for 16 months now for Bipolar-II, rapid cycling, with chronic depression. I also take zoloft & wellbutrin to help with the depression, and I feel *lots* better than 2 years ago. I have read and studied depakote to the point I understand it better than my pdoc. For me, it seems to have worked well.

Here are some things you all should know (of course, YMMV):

1. The dose is unimportant. The valproate level in the blood is what matters. It should be 60-100 nmol/L. For me, at 195 lbs and 39 years old, 500 mg BID gives me a blood level of 65-70. Periodic blood tests are important for two reasons: It is hepatotoxic (destructive to the liver) and to measure the level in the blood. These tests should be done every 2 months for the first year, then 3-4 times a year afterward. (ref: Merck Manual, 1999)

2. There are some significant drug interactions with depakote that must be avoided. These include aspirin (acetaminophen & ibuprophen are OK) and the OTC stomache aids, like pepto-bismol, zantac, tagamet, etc. Also, NEVER break the tablets -- this guarantees gastric upset. (ref: PDR, 2000)

3. To combat hair loss, try adding selenium 200 micrograms and zinc 50 mg daily. Shampoo only with zinc- or selenium- based shampoos (head & shoulders, selsun blue, etc.). The efficacy is anectdotal, but seems to help.

4. To combat weight gain, EXERCISE. Walk, run, bicycle, etc. as much as you can. It also helps depression. I do things like walk 1.5 miles each way to return videos. Start slow, then build up. (ref: common sense & my pdoc).


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