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Re: Depakote and hair loss

Posted by Sunnely on June 13, 2003, at 21:58:01

In reply to Re: Depakote and hair loss, posted by onlyme on June 12, 2003, at 0:02:27

Hair Loss (Alopecia) and Depakote (divalproex sodium or valproate):

First, make sure that the hair loss is not due to other medical/psychiatric reason(s). For example, underactive thyroid can cause cause hair loss. A psychiatric condition called "trichotillomania" (compulsive hair pulling) can also cause hair loss. If other conditions have been ruled, you are psychiatrically stable with Depakote and must remain on this medication, consider taking daily supplement of selenium and zinc.

The recommended daily allowance (RDA) for selenium is 70 mcg (microgram) daily while the RDA for zinc is 15 mg (milligram). For hair loss due to Depakote, higher doses of selenium/zinc combination is recommended such as 200 mcg selenium and 100 mg zinc. Those who are already taking a multivitamin could change to a brand called "One Source" from Wal-Mart, which already contains 200 mcg of selenium. However, it only has the RDA for zinc, so it would still be necessary to take an additional zinc supplement.

Depakote and Pregnancy:

The "Category D" based on the U.S. Food and Drug Administration (FDA) use-in-pregnancy ratings of drugs means there is positive evidence of risk, in this case, Depakote. Category D further indicates that studies in humans, or investigational or postmarketing data, have demonstrated fetal risk. Nevertheless, potential benefits from the use of the drug may outweigh the potential risk. For example, the drug may be acceptable if needed in a life-threatening situation or serious disease for which safer drugs cannot be used or are ineffective.

Depakote can cause teratogenicity (fetal deformities) particularly neural tube defects (e.g., spina bifida, anencephaly) with first-trimester exposure. Offspring of mothers taking valproate have been reported to have an incidence rate of 1% - 1.5%. Women of childbearing age, whether on Depakote or not, should take 400 mcg of folic acid, prophylactically (usually included in once-a-day multivitamins). Women who are on Depakote and planning to become pregnant should discuss this issue with their psychiatrist and obstetrician behorehand. If it is necessary to continue Depakote because of the significant risk of a disruptive relapse of the psychiatric illness during pregnancy, the patient should be started on folic acid 1 mg once a day, early in the pregnancy and an ultrasound should be ordered at 18-20 weeks to assess for fetal abnormalities.


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