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Re: Depakote for unipolar depression? Roslynn

Posted by SLS on November 14, 2022, at 7:56:54

In reply to Depakote for unipolar depression?, posted by Roslynn on November 12, 2022, at 13:45:34

Rosalyn,

I agree with linkadge.


Depakote (valproate) is of great value in resolving and preventing mania in bipolar disorder. I really can't comment on whether or not Depakote is of any value in unipolar depression, although as Linkadge mentioned, it does have a calming effect for some people, seemingly in the absence of bipolar disorder.

If there are any first degree relatives who have inequivocal bipolar disorder, I would begin using treatments known to work in bipolar depression. It is possible that you have the same bipolar genes as other members of family do. "Depression" emerges not as a single-gene trait. Multiple genes are involved. Two bipolar genes and seven major depression genes might yield a disorder that looks and acts like unipolar depression. I don't know how available or expensive genotyping is, but it is not terribly relevant when making clinical decisions. Family history might be more revealing in the long run.

If there are indeed first degree relatives with bipolar disorder, it won't hurt to experiment with treatments known to be particularly effective when treating bipolar depression.

I am particularly partial to LOW-dosage lithium treatment - 300-450 mg/day, but only for depression in the absence of mania. Didn't your doctor reject the idea of using lithium because of kidney concerns? This is easily resolved by:

1. Taking no more than 450 mg/day of lithium. With lithium, kidney damage is dosage-dependent. I can't guarantee that 300 mg/day will prevent additional damage, but I think it likely that it would. If you have sufficient reason to avoid lithium at all costs, then move on. However, if no one can find incidents of 300 mg/day of lithium causing kidney damage, then I would think seriously about trying low-dosage lithium - but for no more than two weeks. My guess is that if you are responsive to lithium, you will feel better within a week. So, if you can't find evidence that low dosages of lithium have been shown to be nephrotoxic, go for it. Remember, for the experiment, you will be on low-dosage lithium for no more that two weeks to see if it works.

2. Take kidney tests before treatment, and then several times during treatment. Simple.

VERY low dosages of lithium seems to prevent Alzheimer's. That was my reason for continuing to take lithium at 300 mg/day when I could not conclude that it was helping my depression. After a decade of my lithium usage of lithium to prevent Alzheimer's, I discovered that my remission was dependent on it. When I tried to discontinue lithium, I relapsed in a big way. Now *that* is dumb luck.

I should try being dumb more often.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

 

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