Posted by SLS on October 22, 2005, at 22:44:03
In reply to Re: Just diagnosed, doc wants me on Depakote. Help!, posted by blueberry on October 18, 2005, at 18:23:00
> My situation was very similar to yours...the good kind of hypomania in the past...but developed into a very distressing kind, racing mind, unable to sit still, feeling like I was going 1000mph, anxiety, depression, all mixed together at the same time. Mixed mania my doc called it. Her first choice was depakote, and I was just as wary as you are, but I gave it a shot.
>
> 500mg of depakote extended release. Talk about fast. I felt the mania ease off and the depression improve on the first day.This has also been my experience with Depakote. It can put the manic fire out within 48 hours if the dose is high enough. For acute episodes of mania, Depakote can be administered using a "loading dose". A loading dose is a high initial dose that serves to bring the blood levels up to a therapeutic level as quickly as posssible. For some drugs, this dose loading is possible because it is generally well tolerated. For me, 1000mg to 1500mg as an initial dose does the job nicely. The loading dose is often higher than the maintenance therapeuic dose is.
> In clinical trials, it usually works within 6 days.
Hmm. I didn't know that.
> I've been on it for 3 weeks.
I hope it continues to treat you well.
For me, when already depressed, Depakote flattens my affect (although not as bad as lithium) and makes me feel moderately more depressed.
I agree that you shouldn't be afraid of the drug. You are only to give it a brief trial to see if it is the right drug for you. It is a much more effective drug for mixed-states than is lithium, particularly in bipolar II. It is well established.
Not everyone will experience the same side effects. I never gained an ounce of weight on it. Others do not experience the flattening of mood that I get with it.
If you don't like it, you can move on to the next drug. However, it is important that you give Depakote an adequate trial such that your blood is tested to be sure that the levels of Depakote are within the therapeutic range.
It is a good idea to get blood tests for liver function several times over the first 6 months of Depakote usage. Please discuss this with your doctor.
Good luck.
- Scott
poster:SLS
thread:568610
URL: http://www.dr-bob.org/babble/20051017/msgs/570698.html