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Dr. Bob is Robert Hsiung, MD,
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Posted by Nickengland on June 17, 2005, at 11:36:53
..vs Valproic acid
Out of these 3, bearing in mind they are all more or less the same medication (valproate) is any one better for lac of side effects?
I have taken sodium valproate once before, and am now considering going back on a valproate again and wonder if there would be any benefit of choosing Valproate semisodium (Depakote), over sodium valproate?...would there be a chance of less weightgain in particular??
To be perfectly honest im not to bothered about valproic acid.
Also to any depakote users here...are there any of you who "havent" gained weight?
Many thanks & Kind regards
Nick
Posted by yesac on June 17, 2005, at 12:49:12
In reply to Valproate semisodium vs Sodium Valproate....., posted by Nickengland on June 17, 2005, at 11:36:53
I gained about 5 pounds on brand name Depakote.
I have heard (from my psychiatrist and just other stuff I've read) that there is a big difference between brand name Depakote and generic valproic acid. I think that they all most likely will make you gain weight, but other side effects might not be as bad on Depakote. My shrink wouldn't even prescribe generic.
Posted by ed_uk on June 17, 2005, at 15:50:03
In reply to Valproate semisodium vs Sodium Valproate....., posted by Nickengland on June 17, 2005, at 11:36:53
Hi Nick!
In the UK............
Sodium valproate (Epilim, Orlept) is approved only for epilepsy.
Valproic acid (Convulex) is approved only for epilepsy.
Valproate semisodium (Depakote) is approved only for the treatment of manic episodes associated with bipolar disorder. It is not approved for prophylaxis. Valproate semisodium is called divalproex in the US. Valproate semisodium consists of a 1:1 mixture of valproic acid and sodium valproate.
Epilim Chrono also contains a mixture of sodium valproate and valproic acid, but not in a 1:1 ratio. Unlike other UK valproate formulations, Epilim Chrono tablets are not enteric coated. Most valproate formulations are enteric coated in order to reduce the risk of gastric irritation. Since Epilim Chrono is controlled release, I don't think it will make much difference that it's not enteric coated. Nevertheless, if Epilim Chrono irritates your stomach, it might be worth trying Depakote - which is enteric coated. Orlept and standard-release Epilim tablets are also enteric coated.
RE licensing/approval.........what a medication is approved for doesn't make that much difference to be honest. Your doc can prescribe whatever s/he wants to prescribe! I'm not even sure why I brought it up :-O
I think Epilim Chrono (controlled release) might be the best choice for you because it can generally be taken once daily. Then again, if you're already taking Neurontin three times a day I suppose it doesn't make that much difference. If you've got bad memories of Epilim Chrono you might prefer to try Depakote! Depakote is usually take two or three times a day. At the moment, controlled release Depakote is not available in the UK.
For the purpose of maintenance treatment, I think it would be useful to ensure that you always get a prescription for the same brand name.
'.....it is important to note that valproate semisodium 500 mg tablets contain 15.5% more valproic acid equivalent than sodium valproate 500 mg tablets.........'
See........http://pb.rcpsych.org/cgi/content/full/27/12/446
>Out of these 3, bearing in mind they are all more or less the same medication (valproate) is any one better for lack of side effects?
Epilim vs Depakote. In general, I think there's very little difference.
>....would there be a chance of less weight gain in particular??
I think it's very unlikely :-( :-(
Kind regards,
Ed.
Posted by Nickengland on June 18, 2005, at 11:24:50
In reply to Re: Valproate semisodium vs Sodium Valproate....., posted by yesac on June 17, 2005, at 12:49:12
Hi yesac
Thanks for replying, thats interesting to know :-)
Looks like if I do go on Valproate I'll definately make sure I use brand then to cut down on side effects.
Kind regards
Nick
Posted by Nickengland on June 18, 2005, at 11:40:56
In reply to Re: Valproate semisodium vs Sodium Valproate..... » Nickengland, posted by ed_uk on June 17, 2005, at 15:50:03
Hi Ed!
Very interesting read, thanks for that information :-)
I remember I actually took Epilim Chrono before...I think if I did go back on Valproate it would either be Epilim Chrono or Depakote I use then, shame they don't have the slow release version here in the uk..
With dosage, I was on 400mg of Epilim Chrono divided in to 2 doses as I remember corectly although I think I just took it all at once. If I was to take Depakote, would the equivilent dosage of this be 400mg too or any different?
Seems quite strange Valproate semisodium is licensed for mania but the others are not. When it comes down to maintanance though, out of Depakote vs Epilim Chrono there really wouldn't be any difference if at all you think?I don't remember Epilim Chrono irritating my stomach so thats good I guess..Just out of curosity do you know the ratio of sodium valproate and valproic acid in Epilim Chrono?..Depakote is an exact 50/50 mix of both of these right?
Thanks very much for this information Ed :-)
Kind regards
Nick
Posted by ed_uk on June 18, 2005, at 14:51:39
In reply to Re: Valproate semisodium vs Sodium Valproate..... » ed_uk, posted by Nickengland on June 18, 2005, at 11:40:56
Hi Nick!
>I think if I did go back on Valproate it would either be Epilim Chrono or Depakote I use then, shame they don't have the slow release version here in the uk.......
I don't think Depakote ER would be any better than Epilim Chrono :-)
>With dosage, I was on 400mg of Epilim Chrono divided in to 2 doses as I remember corectly although I think I just took it all at once.
Yes, it's sometimes taken twice daily, sometimes once daily.
>If I was to take Depakote, would the equivilent dosage of this be 400mg too or any different?
The equivalent dose of Depakote would be very close to 400mg but not exactly. Since Depakote only comes in 250mg and 500mg tablets, the closest dose would be 250mg twice a day. The tablets are not supposed to be cut in half.
>When it comes down to maintanance though, out of Depakote vs Epilim Chrono there really wouldn't be any difference if at all you think?
No significant difference IMHO :-) Your doc might like the fact that Depakote is licensed for mania. You might like the fact that Epilim Chrono can (usually) be given once daily!
>Just out of curosity do you know the ratio of sodium valproate and valproic acid in Epilim Chrono?
2.3:1 (sod val:valproic acid)
Kind regards,
Ed.
Posted by Nickengland on June 19, 2005, at 6:20:05
In reply to Re: Valproate semisodium vs Sodium Valproate..... » Nickengland, posted by ed_uk on June 18, 2005, at 14:51:39
Thanks for supplying such accurate information Ed! :-)
9 days until the psychiatrist appointment. I have realised now I don't get enough or any stabilisation with Neurontin..for me it is just not a mood stabiliser! lol But It has solved one problem that no other drug has been able to do so far and that is reduce anxiety :-) Very pleased with the results there, slight weight gain, but i'll work to burn that off hopefully.
Topamax or Epilim Chrono...that is the question! I think I may prefer Topamax, its a close call. Could these 2 be combined safely just out of interest? I understand gabapentin has no interactions with these 2 right?
Thanks Ed :-)
Nick
Posted by ed_uk on June 19, 2005, at 10:51:20
In reply to Re: Valproate semisodium vs Sodium Valproate..... » ed_uk, posted by Nickengland on June 19, 2005, at 6:20:05
Hi Nick!
>But It has solved one problem that no other drug has been able to do so far and that is reduce anxiety.........
:-)
>Could these 2 be combined safely just out of interest?
Topamax + Epilim? Yes, as far as I know you can combine them - might cause cognitive side effects though.
>I understand gabapentin has no interactions with these 2 right?
I don't know of any :-)
Kind regards,
Ed.
Posted by Nickengland on June 19, 2005, at 15:47:12
In reply to Re: Valproate semisodium vs Sodium Valproate..... » Nickengland, posted by ed_uk on June 19, 2005, at 10:51:20
This is the end of the thread.
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