Depakote for Bipolar Disorder

Bipolar Mood Stabilizers Library


Depakote (divalproex sodium, sodium valproate, and valproic acid) is an anticonvulsant (anti-seizure) medication used as a mood stabilizer in the treatment of bipolar disorder. Depakene contains the same medication— the difference is that Depakote is coated, which is thought to decrease some of the gastrointestinal side effects.

Depakote is approved by the U.S. Food and Drug Administration for the treatment of manic or mixed episodes, with or without psychotic features.

It is also approved to treat migraines and epilepsy and is frequently prescribed for people who have hypomania.

This drug is available in a variety of forms and dosages, including capsules, sprinkles, extended-release capsules and oral solutions.

Depakote levels are routinely followed through with blood tests to make sure you have neither too little nor too much in your system: Too little will render it ineffective while too much may be toxic.

Depakote Side Effects

The most common side effects of Depakote, when used for bipolar disorder, are somnolence, dyspepsia, nausea, vomiting, diarrhea, dizziness, abdominal pain, and rash, along with unusual weight gain or loss. Also, hair loss can occur for a time.

Depakote Warnings

There is some risk of increased suicidal ideation and behavior in patients being treated with this category of anticonvulsants. For more, see FDA Orders "Suicidal Ideation" Warning on Many Mood Stabilizers.

There has been some correlation of Depakote with liver problems, so your doctor may check liver function with blood tests. Depakote can rarely cause pancreatitis, and if this diagnosed, valproate should ordinarily be discontinued. Symptoms that can indicate liver or pancreas problems include dark urine, nausea, vomiting, clay-colored stools, upper stomach pain, loss of appetite, low fever, or jaundice (yellowing of the skin or eyes).

Emergency medical attention is needed if these symptoms appear.

In elderly patients, dosage adjustment and close monitoring of potential side effects will be important.

Depakote and Pregnancy

Depakote should only be used with extreme caution during pregnancy. Birth defects, such as spina bifida, are up to 10 times as likely to occur, and developmental problems, such as lowered IQ, have been reported.

The FDA recommends that dietary folic acid supplementation both prior to and during pregnancy should be routinely recommended to patients taking Depakote who are contemplating pregnancy. Folic acid has been shown to reduce the risk of certain birth defects.

Depakote is excreted in breast milk. According to the FDA, strong consideration should be given to discontinuing nursing when Depakote is given to a nursing woman, as it may harm the infant. If you plan to nurse a child, make sure your doctor knows you are taking Depakote.

Drug Interactions

Taking Depakote and Lamictal (lamotrigine) together can increase the likelihood of serious skin rashes, including Stevens-Johnson Syndrome and toxic epidermal necrolysis. Lamictal dosage should be reduced when co-administered with Depakote.

There are many other medications that can interact with Depakote and increase potential side effects, including common drugs, like aspirin.

You should inform your doctor about all other medications, including over-the-counter ones, that you are taking along with Depakote.

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