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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by cache-monkey on April 10, 2005, at 1:19:11
Hey all,
Mitch posted in another thread about getting poor sleep on Depakote. (I've included it again below.) I think I might be experiencing the same. I've been having trouble getting to sleep. Well, that's normal. But I feel like my sleep is a bit more light and fitful. And then I'm groggy all day until a couple hours before my next dose in the evening. At which point I perk up again. Cycle repeats. Maybe this will stabilize over time?
I'm wondering, though, if this has something to do with the ER formulation. The time to peak concentration seems to range from 4-17 hours. So, could part of the morning grogginess be it be that I'm just getting the peak effects when I wake up, rather than while I'm sleeping? Would taking it earlier in the day mitigate some of this?
Any thoughts would be greatly appreciated.
Best,
cache-monkey<< Just thought I'd chime in here about potential sleep disruptive effects of Depakote. I've had trouble with staying asleep (early morning awakenings and tired next days), while on Depakote. Thought.. it was just AD's other meds causing trouble, or maybe apnea, whatever, but I think it's the Depakote. It does wonders for temper and cycling, but seems to mess with sleep architecture. I've eliminated all the other variables I can think of. It does tend to be sedative *generally*, but seems to worsen sleep hygiene for me particularly. >>
Posted by HappyGirl on April 10, 2005, at 11:47:48
In reply to Depakote (ER) and poor sleep ... Dose timing?, posted by cache-monkey on April 10, 2005, at 1:19:11
Hi:
When I was rx'ed Depakote for the first time, ... from 500 mg. to 1,250 mg., it made me REALLY sleepy not only nightly also even day-time. Then, I recall, ... yes, I slept a lot, around 12 hours to even 15 hours except eat and walk/exercise(for my brain-chemical production's sake). In any case, the Depakote was like 'sleeping pill' for me, rather a mood-stabilizer to control my Bp.However, some of Bper's with Depakote has 'sleeping' problem like you, ... then, it is NOT a very first time to hear/read this. In my guess, ... those who get 'sedating' effect from the Depakote has MORE 'depressive' type of Bp, while people with sleeping problem seems to have 'hypomanic' Bp. But, this is my VERY 'personal' opinion/view.
In regard to 'feel groggy' during the day, ... in my hunch, ... you may still has 'depression' that is not controlled by the Depakote. This is also my personal experience on Depakote, this med. is NOT a 'potent' M.S. to begin with, rather is good for 'milder' case of Bp. Thus, Depakote is widely rx'ed as a very first-line M.S. for newly dx'ed with Bp. Actually, it didn't help my Bp except a sleep/rest for calming me down, since my case has been a moderate to severe case of Bp, mixed/ultra-rapid Bp.
In my suggestion, ... try to take Depakote ER three to four hours before going to the bed. Or, try to switch a regular type of Depakote which has immediate effect to make you sleepy. Along with Depakote, you may need some form of A.D. or a sedating med., if persistent. Because, 'Sleep'/rest is one of critical components to get/feel well.
H.G.
Posted by Ritch on April 10, 2005, at 14:34:39
In reply to Depakote (ER) and poor sleep ... Dose timing?, posted by cache-monkey on April 10, 2005, at 1:19:11
...
>With the Depakote, I do seem to be having more trouble falling asleep, although there could be other things going on as well. I seem to feel more energized after dosing (ER version), rather than sedated. And my sleep seems a little more light, dream-filled and fitful. I'm considering moving my dose time to an earlier part of the day to see if that helps.
...
> I'm wondering, though, if this has something to do with the ER formulation. The time to peak concentration seems to range from 4-17 hours. So, could part of the morning grogginess be it be that I'm just getting the peak effects when I wake up, rather than while I'm sleeping? Would taking it earlier in the day mitigate some of this?
>
> Any thoughts would be greatly appreciated.
>
> Best,
> cache-monkey
>...
>With the Depakote, I do seem to be having more trouble falling asleep, although there could be other things going on as well. I seem to feel more energized after dosing (ER version), rather than sedated. And my sleep seems a little more light, dream-filled and fitful. I'm considering moving my dose time to an earlier part of the day to see if that helps.
...And my sleep seems a little more light, dream-filled and fitful...Hi CM, that's EXACTLY the type of trouble I've been having with it. I talked to my pdoc about timing as well, and it was suggested I take it at a different time. I tried taking first thing in the morning when I get up. Didn't like that because while I was working it was kicking in and fogged me up too much. Tried midday, and I got too hungry in the evenings.. and I wanted to go asleep too *early*, then would have broken, fractured sleep with next day fatigue. I found the best time was about 2 hrs just before bedtime. Any sooner and I would get sleepy too quickly, right at bedtime I would be too sleepy when I got up. I think H.G's suggestion about using the regular EC version *might* be better for you. However, I think that Depakote aggravates a tendency I have to want to go to sleep later and later. Back during my wintertime depression (when this particular problem was really bad), I could FIX it (temporarily)... All I did was force myself to stay awake an extra 2-3 hrs., go to sleep later, and NOT set an alarm clock (and not have to get up the next day). And it worked! It is a delayed phase thing of some kind. It really is the only big gripe I've got about Depakote. Right now, I'm taking an antihistamine to sleep more soundly (dimenhydrinate), and that's working thus far, but this is really annoying. Oh, yeah, there have also been times where I've taken an extra dose in the daytime (when I'm getting manic sx), and I find I'm actually revved up even more in some ways... really strange. I hope somebody else posts some recommendations... Mitch
Posted by Spriggy on April 10, 2005, at 17:03:33
In reply to Re: Depakote (ER) and poor sleep ... Dose timing? » cache-monkey, posted by Ritch on April 10, 2005, at 14:34:39
Maybe it is the ER version because I was on the regular version and took it right before bed with no sleep problems.. Except for it would give me horrific heartburn.
Other than that, no problems going beddy bye.
Posted by cache-monkey on April 11, 2005, at 12:31:30
In reply to Re: Depakote (ER) and poor sleep ... Dose timing? » cache-monkey, posted by HappyGirl on April 10, 2005, at 11:47:48
Hey,
Thanks for the input. I had been thinking that my grogginess during the day has to do with poor sleep at night. You're right that there could be an untreated component to my 'depression.' But I'm starting to think that what I had been describing as depression is really some sort of mixed state/dysphoria. Which is why I'm trying the MS route before going back to an AD.
I tried moving my Depakote dose earlier in the evening and that helped somewhat last night/this morning. I think I'll give it a few days to assess...
Thanks,
cache-monkey> Hi:
> When I was rx'ed Depakote for the first time, ... from 500 mg. to 1,250 mg., it made me REALLY sleepy not only nightly also even day-time. Then, I recall, ... yes, I slept a lot, around 12 hours to even 15 hours except eat and walk/exercise(for my brain-chemical production's sake). In any case, the Depakote was like 'sleeping pill' for me, rather a mood-stabilizer to control my Bp.
>
> However, some of Bper's with Depakote has 'sleeping' problem like you, ... then, it is NOT a very first time to hear/read this. In my guess, ... those who get 'sedating' effect from the Depakote has MORE 'depressive' type of Bp, while people with sleeping problem seems to have 'hypomanic' Bp. But, this is my VERY 'personal' opinion/view.
>
> In regard to 'feel groggy' during the day, ... in my hunch, ... you may still has 'depression' that is not controlled by the Depakote. This is also my personal experience on Depakote, this med. is NOT a 'potent' M.S. to begin with, rather is good for 'milder' case of Bp. Thus, Depakote is widely rx'ed as a very first-line M.S. for newly dx'ed with Bp. Actually, it didn't help my Bp except a sleep/rest for calming me down, since my case has been a moderate to severe case of Bp, mixed/ultra-rapid Bp.
>
> In my suggestion, ... try to take Depakote ER three to four hours before going to the bed. Or, try to switch a regular type of Depakote which has immediate effect to make you sleepy. Along with Depakote, you may need some form of A.D. or a sedating med., if persistent. Because, 'Sleep'/rest is one of critical components to get/feel well.
> H.G.
Posted by cache-monkey on April 11, 2005, at 12:38:20
In reply to Re: Depakote (ER) and poor sleep ... Dose timing? » cache-monkey, posted by Ritch on April 10, 2005, at 14:34:39
> ...And my sleep seems a little more light, dream-filled and fitful...
>
> Hi CM, that's EXACTLY the type of trouble I've been having with it. I talked to my pdoc about timing as well, and it was suggested I take it at a different time. I tried taking first thing in the morning when I get up. Didn't like that because while I was working it was kicking in and fogged me up too much. Tried midday, and I got too hungry in the evenings.. and I wanted to go asleep too *early*, then would have broken, fractured sleep with next day fatigue. I found the best time was about 2 hrs just before bedtime. Any sooner and I would get sleepy too quickly, right at bedtime I would be too sleepy when I got up. I think H.G's suggestion about using the regular EC version *might* be better for you. However, I think that Depakote aggravates a tendency I have to want to go to sleep later and later. Back during my wintertime depression (when this particular problem was really bad), I could FIX it (temporarily)... All I did was force myself to stay awake an extra 2-3 hrs., go to sleep later, and NOT set an alarm clock (and not have to get up the next day). And it worked! It is a delayed phase thing of some kind. It really is the only big gripe I've got about Depakote. Right now, I'm taking an antihistamine to sleep more soundly (dimenhydrinate), and that's working thus far, but this is really annoying. Oh, yeah, there have also been times where I've taken an extra dose in the daytime (when I'm getting manic sx), and I find I'm actually revved up even more in some ways... really strange. I hope somebody else posts some recommendations... MitchI also have problems with delayed phase syndrome. The Depakote seemed to be making things a little worse. But, I tried dosing earlier yesterday. After about 5-6 hours I was ready for bed. Waking up was still hard to do, but that's pretty much always the case. I'm going to give this a few more days and see if I can settle into a more regularized sleep pattern.
Thanks for the input,
cache-monkey
This is the end of the thread.
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