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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 26. Go back in thread:
Posted by Caedmon on April 24, 2006, at 23:35:06
In reply to Why are so many people down on Depakote?, posted by greywolf on April 24, 2006, at 22:40:30
>
> I keep reading horrible things people have to say about Depakote, yet about 6 weeks in and it's one of the easiest meds I've ever tried. You name the SSRI, SNRI, NDRI, TCA, and I've been on it, and almost all of them have SEs I found intolerable in light of their relative therapeutic ineffectiveness.
>
> While I've obtained at least some mood stabilization from Depakote at 1250mg/day (not much, but enough to notice) with just slight fogginess and some vision blurring that I can't really tag Depakote with, it's a far cry from the typical SSRI SEs I experienced (moderate to severe fatigue, nausea, dizziness, etc.).>>Hey greywolf, I don't know the answer to your question but I have sometimes felt that mood stabilizers get a bad rep. The anticonvulsants can be pretty tolerable actually. I mean, they're not perfect, but neither is some of the stuff you go through on antidepressants.
I have my eye on Depakote for future use, I might want to try a valproate. I guess males tend to tolerate valproates pretty well, and I tend to only need subtherapeutic doses of AEDs for them to help my bipolar disorder. So, it would probably be a decent pick.
Best of luck with Mr. Divalproex!
- C
Posted by Phillipa on April 24, 2006, at 23:55:00
In reply to Re: Why are so many people down on Depakote? » greywolf, posted by Caedmon on April 24, 2006, at 23:35:06
They also using mood stabalizers for other conditions than bipolar illness. I was given low dose trileptal for help with benzos for sleep. good luck greywolf hope it keeps working for you. Love Phillipa
Posted by med_empowered on April 25, 2006, at 0:16:27
In reply to Re: Why are so many people down on Depakote?, posted by Phillipa on April 24, 2006, at 23:55:00
I'm just down on Depakote b/c I personally didn't like it, and I think its over-used and sometimes used at excessively high doses for kind of questionable purposes ("anger management"--please). Glad you're having good results, though.
Posted by blueberry on April 25, 2006, at 5:35:17
In reply to Why are so many people down on Depakote?, posted by greywolf on April 24, 2006, at 22:40:30
My only complaint with depakote was that it only provided good benefits for the first 3 days and then nothing after that. My mood improved dramatically and the mood swings stopped. But after 3 days, mood again dropped and the swings returned. Dosage increase didn't do anything except magnify the fogginess side effect.
The brain fog side effect was the only side effect for me, other than weight gain which was desirable for me. If the depakote had kept working, I would not have minded the brain fog. I just didn't want to have that side effect when the med wasn't doing anything for me.
Posted by Glydin on April 25, 2006, at 6:52:40
In reply to Re: Why are so many people down on Depakote?, posted by blueberry on April 25, 2006, at 5:35:17
Internet posting sites also have horrible things to say about the med I take and am having great success with. As a generally find, well, that can be what you find. Everyone's experiences and opinions are usually based on their personal findings and most folks will "vent" about failures and misgivings rather than successes, so the view may appear a bit slanted.
The specifics of the complaints may be from the class or actions of the meds, but I think the fact is, we can't generalize - one person's nightmare, h*ll time or ineffectiveness is another's relief, paradise and wonderful. AND all levels inbetween.
Enjoy your good findings, I'm very happy for you.
Posted by Caedmon on April 25, 2006, at 8:04:21
In reply to Re: Why are so many people down on Depakote?, posted by Glydin on April 25, 2006, at 6:52:40
>> Everyone's experiences and opinions are usually based on their personal findings and most folks will "vent" about failures and misgivings rather than successes, so the view may appear a bit slanted.>>
I agree. I have to say, I find this frustrating, personally, when the experiences of one person are generalized to other people. There will always be horror stories. I don't know, I guess it's probably human nature. Sort of a, "Hot stove burned me, so don't touch the hot stove," immediate conditioned response thing.
An example: I take risperidone in cycles (usually about 4 weeks) for mania and sometimes for anxiety/depression. If I had simply gone off of what some of my inquiries about the med were, from internet postings, you'd think that Risperdal were nothing more than a great way to make me tired, stupid, fat, diabetic, dyskinetic, and certainly no better for the wear. Turns out, I respond well to it, and it works great for the purposes that I take it. It is an instance where I'm glad I ignored what others had to say. :D
- C
Posted by greywolf on April 25, 2006, at 8:30:55
In reply to Re: Why are so many people down on Depakote? » Glydin, posted by Caedmon on April 25, 2006, at 8:04:21
Thanks all for your comments.
Depakote isn't providing any breakthrough for me, but I do notice some improvement. That's a plus right there because, other than Nardil, the ADs I've been on have offered little noticeable improvement at the cost of signficant SEs (particularly the SSRIs).
Of course, prior to being rx'd Depakote, I paid no attention to threads about it, but over the last couple months I've noticed negative Depakote comments more and more. Sometimes, these comments refer to the "horrors" of Depakote, yet provide nothing in the way of specifics (like someone actually experiencing liver damage, blindness, serious hair loss, etc.).
I'm just trying to figure out if the lore of Depakote's getting in the way of its truth.
Posted by MidnightBlue on April 25, 2006, at 10:33:30
In reply to Why are so many people down on Depakote?, posted by greywolf on April 24, 2006, at 22:40:30
I took depakote for many many years. It was given to me at first to help prevent horrible almost daily migraine headaches. I gained 100 pounds. I had more frequent, heavy, very painful periods. I had problems with nausea, dizziness, stomach pain, foggy brain. At first I got ulcers in my mouth/throat. Those eventually went away.
The plus side? It did help me sleep at night if I took the whole dose at once. (My doc said I could do that.) It reduced the migraines by about 50% and I had to go to the emergency room less. This was years ago before all the new migraine meds.
It did absolutely nothing to help my depression and I think might have made it worse. I am not bipolar (though several doctors wanted to hang that label on me when I didn't respond to SSRIs) and it seemed to damp down any positive or creative thoughts. My pdoc STILL didn't understand why I didn't get better when he pushed the dose from 1000 to 1250. Only the side effects got worse! Maybe the drug wasn't working for me? DUH!
I have a friend who DID have liver damage from depakote. And oh yeah, I did have problems with my hair falling out! My gyn has said it can cause polycystic ovary disease.
My feeling is if you REALLY REALLY need the drug to stabilize mood or for epilepsy then take it. Otherwise if there is ANYTHING else you could take, try that first.
It is not the worst drug out there. But it is serious medication.
MB
Posted by greywolf on April 25, 2006, at 11:31:00
In reply to Re: Why are so many people down on Depakote? » greywolf, posted by MidnightBlue on April 25, 2006, at 10:33:30
Now, that's a horror story.
I'm sorry those things happened to you, Midnight Blue. Sounds like a bad time. I am fortunate that I haven't experienced such SEs (yet). But I will keep your experience in mind.
Posted by bprandy on April 25, 2006, at 12:20:59
In reply to Re: Why are so many people down on Depakote? » MidnightBlue, posted by greywolf on April 25, 2006, at 11:31:00
Unrelenting intestinal discomfort. I was on it for a year and it was horrible. Stomach cramps, gas,and every other digestive problem you can think of. It remains the only med I really had a bad time with.
Posted by yxibow on April 25, 2006, at 12:58:45
In reply to Re: Why are so many people down on Depakote?, posted by bprandy on April 25, 2006, at 12:20:59
Yes, I've heard about hair loss and some of the above, although I never experienced it, since I already have hair thinning anyhow due to whatever genetic reason. I've been through the list of AEDs, including Depakote which didnt seem to do too much for me but it was only for a month or two, which I guess is a trial.
I now await the effects of Lyrica. I can already sense the side effects -- transient blurry (or bleary) vision, and possible increase in appetite but the dose is still cautiously small (25, now 50 mg) by my doctor as I am already on Neurontin and other things that could push GABA to seizure levels in rare cases as too much GABA floating around also can do bad things as too little.Gabitril and Keppra are the only other things that I havent tried, and I'm not thrilled about the seizure potential of tiagabine, and Keppra increases psychosis (not that I have it but the somatiform disorder I have mimics it slightly though I'm perfectly sane.)
But back to Depakote, it is a good medication for Bipolar as is Lithium, just less harsh -- so it has its place, I just don't know how much it would help me.
Cheers
-- Jay
Posted by Glydin on April 25, 2006, at 14:46:01
In reply to Re: Why are so many people down on Depakote? » Glydin, posted by Caedmon on April 25, 2006, at 8:04:21
> I agree. I have to say, I find this frustrating, personally, when the experiences of one person are generalized to other people. There will always be horror stories. I don't know, I guess it's probably human nature. Sort of a, "Hot stove burned me, so don't touch the hot stove," immediate conditioned response thing.~~~ Yep.
I think most folks have been around the psych neighborhood and realize that critical thinking for oneself with using as much as is possible or wanted for resource to make an informed decision. What does bother me is new folks or those who tend to be a little med phobic could take in all the negative and may miss out on something that could be of help without alot of pitfalls.
When I first arrived in the "search the 'net mode for psych advice" four years ago, I was into my third week of JUST beginning to do well on Klonopin. At that time, there were more folks posting who had problems with benzo's and I received more "gloom and doom" postings than those that were anywhere near positive. I understand that.... but it scared the beeeegeeebies out of me and I discontinued it. I decompensated quickly. I resumed and did well for several years. My status changed and I was able to recover utilizing another med. I'm lucky but I KNOW I'm not the only one having chemical enhancement success and contentment. It took me a while to understand how things worked but I did finally get it. I have a friend who is fond of saying: "There are few happy stories on the internet".
Posted by greywolf on April 25, 2006, at 16:00:19
In reply to Re: Why are so many people down on Depakote? » Caedmon, posted by Glydin on April 25, 2006, at 14:46:01
I take the negative postings with a grain of salt because I think it's a truism that those with negative experiences are generally more motivated to let others know than those who positive experiences.But with Depakote I am a little more concerned because the "horror" stories weren't about withdrawal problems or run-of-the-mill SEs. The non-specific negative posts left me wondering what the heck could have happened to that person to make the experience so bad, and most of the posts that actually stated grounds did not fall into the "horror" camp.
From my subjective perspective, it seems that the negative Depakote posts are a bit more strident about the med than is usually seen with the typical ADs written about in these threads. And, given that I have had unhappy experiences with most ADs that are available but have not yet experienced adverse effects with Depakote to the degree I normally would with, for example, an SSRI, I started wondering how bad this Depakote could get.
Posted by Glydin on April 25, 2006, at 16:34:18
In reply to Re: Why are so many people down on Depakote?, posted by greywolf on April 25, 2006, at 16:00:19
> From my subjective perspective, it seems that the negative Depakote posts are a bit more strident about the med than is usually seen with the typical ADs written about in these threads. And, given that I have had unhappy experiences with most ADs that are available but have not yet experienced adverse effects with Depakote to the degree I normally would with, for example, an SSRI, I started wondering how bad this Depakote could get.
~~~ You could be correct about the intensity
of the negative posts on Depakote. I'm on a SSRI and that's where I see the really negative posts. So, it may be based on what one person is looking at/for versus another. I also think it cycles as to the "med of the time", for whatever reason. When there's a new med out that, of course, that causes a buzz, otherwise I see the others kinda cycle. It may a point of prespective... or not.
Posted by bipolarspectrum on April 25, 2006, at 17:22:52
In reply to Re: Why are so many people down on Depakote?, posted by blueberry on April 25, 2006, at 5:35:17
Hey Blue,
I experience the same thing with mood stabilizers! On both tegretol and trileptal (and now possibly Depakote) I get an initial mood boost and stoppage of cycling.. but this never lasts past a few days mabye a week.. what r u doing for this??
bps> My only complaint with depakote was that it only provided good benefits for the first 3 days and then nothing after that. My mood improved dramatically and the mood swings stopped. But after 3 days, mood again dropped and the swings returned. Dosage increase didn't do anything except magnify the fogginess side effect.
>
> The brain fog side effect was the only side effect for me, other than weight gain which was desirable for me. If the depakote had kept working, I would not have minded the brain fog. I just didn't want to have that side effect when the med wasn't doing anything for me.
Posted by blueberry on April 25, 2006, at 18:46:50
In reply to Blueberry, posted by bipolarspectrum on April 25, 2006, at 17:22:52
It might sound strange and certainly goes against what psychiatrists believe, but for me the best mood stabilizers are actually long halflife antidepressants, and actually prozac is the only one that fits that bill. Prozac was never a great antidepresant all by itself for me, but as a mood stabilizer it was flawless.
I sure did like the way depakote felt though. Darn it all if it only lasted 3 days. What a tease. Years ago lamictal was the same way. With each dose increase I had a couple good days, and then I was back to where I was.
I am not committed to it and I'm still unsure of what to do, but 3 days ago I restarted prozac at 2.5mg (I am so sensitive right now I couldn't possibly tolerate a regular dose of anything). Already in just 3 days things have smoothed out. My fear and paranoia has dropped a lot in 3 days, daily cycles have smoothed out a lot, mood hasn't improved much though.
> Hey Blue,
>
> I experience the same thing with mood stabilizers! On both tegretol and trileptal (and now possibly Depakote) I get an initial mood boost and stoppage of cycling.. but this never lasts past a few days mabye a week.. what r u doing for this??
> bps
>
> > My only complaint with depakote was that it only provided good benefits for the first 3 days and then nothing after that. My mood improved dramatically and the mood swings stopped. But after 3 days, mood again dropped and the swings returned. Dosage increase didn't do anything except magnify the fogginess side effect.
> >
> > The brain fog side effect was the only side effect for me, other than weight gain which was desirable for me. If the depakote had kept working, I would not have minded the brain fog. I just didn't want to have that side effect when the med wasn't doing anything for me.
>
>
Posted by Phillipa on April 25, 2006, at 19:08:02
In reply to Re: Why are so many people down on Depakote? » greywolf, posted by Glydin on April 25, 2006, at 16:34:18
Glydin you are absolutely right as the last two weeks have been all about MAOI's and the ENSAM patch. I just gather info and since the drug rep hasn't even been to my pdocs about ENSAM I will wait and stick with the SSRI's. Love Phillipa
Posted by BrianBoru on April 26, 2006, at 10:00:13
In reply to Why are so many people down on Depakote?, posted by greywolf on April 24, 2006, at 22:40:30
I just returned from a short-term care facility where I saw several patients on Depakote. They were zombies. My younger brother, who has Down syndrome, is on Depakote too. He used to be an active kid (loved to play baseball and basketball). Now he either stares or sleeps all day.
Posted by greywolf on April 26, 2006, at 11:32:23
In reply to Re: Help Dealing with Hospital Abuse, posted by BrianBoru on April 26, 2006, at 10:00:13
Yeah, I can imagine that's tough in the hospital. But, I'm talking more about therapeutic dosages administered outside of a hospital setting.
Posted by Caedmon on April 26, 2006, at 17:15:16
In reply to Re: Help Dealing with Hospital Abuse, posted by BrianBoru on April 26, 2006, at 10:00:13
> I just returned from a short-term care facility where I saw several patients on Depakote. They were zombies.>
What were they like before they took Depakote? Do you know?
- C
Posted by BrianBoru on April 26, 2006, at 17:37:11
In reply to Re: Help Dealing with Hospital Abuse » BrianBoru, posted by Caedmon on April 26, 2006, at 17:15:16
Yes, I know what they were like - especially my own brother.
Posted by Caedmon on April 26, 2006, at 22:50:15
In reply to Re: Why are so many people down on Depakote?, posted by BrianBoru on April 26, 2006, at 17:37:11
> Yes, I know what they were like - especially my own brother.>
I was curious about the people in the acute care facility, actually.
- C
Posted by UgottaHaveHOPE on April 27, 2006, at 10:51:07
In reply to Re: Why are so many people down on Depakote? » BrianBoru, posted by Caedmon on April 26, 2006, at 22:50:15
or does it just turn you into a zombie? im confused.
Posted by Phillipa on April 27, 2006, at 19:17:13
In reply to Re: Can ppl take Depakote and still function?, posted by UgottaHaveHOPE on April 27, 2006, at 10:51:07
Post a thread asking just that. Love Phillipa
Posted by yxibow on April 28, 2006, at 13:49:40
In reply to Re: Can ppl take Depakote and still function? » UgottaHaveHOPE, posted by Phillipa on April 27, 2006, at 19:17:13
> Post a thread asking just that. Love Phillipa
I dunno, it depends on the dose I suppose -- I'm a fast metabolizer of everything it seems and I can take high doses and function on most psychiatric drugs to a degree or another -- except Seroquel. I wish they would combine the least side effecst of Seroquel with the greater efficacy of Zyprexa and remove the antihistamine properties of Seroquel. But that's neither here nor there. I still fog through the morning on Seroquel.
This is the end of the thread.
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