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Depakote Side Effects, Withdrawal and FAQs

Depakote, (valproate), is an anti-seizure medication that can cause paradoxical seizures which are potentially life-threatening, on abrupt withdrawal of the drug.
It is used in the treatment of some seizure disorders, i.e., epilepsy, manic episodes of bipolar disorder, or to prevent migraines.

Where a drug does not have an adequately robust body of documented and accessible history of clinical trials to rely on, one might be well-advised to research such a medication as carefully and as thoroughly as possible to make an informed decision before beginning a prescription. Some of this important information will be outlined below.

It is vital to note that Depakote (valproate, et al.) was approved for treating bipolar disorder after only very short trials were done on hospitalized acute mania patients. No long-term trials were ever completed that demonstrated the long-term safety or effectiveness of Depakote. Nonetheless, Depakote has been prescribed to millions of people since its approval in 1983.

There is a much larger body of evidence that has accumulated post-marketing of the drug that includes adverse side effects, symptoms of withdrawal and other information which we will cover below.

Always seek reliable medical advice before starting or stopping a prescription drug such as Depakote.

What is Depakote Used For?

Depakote is used in the treatment of seizure disorders, often in combination with other medications that can manage seizure disorders.

Bipolar disorder is also treated with Depakote, where mania or hypomania presents. Manic episodes are described as distinct periods of abnormally sustained elevated mood that is sometimes combined with other characteristics potentially including irritability and hostility. Other typical symptoms include machine-gun type speech, reduced need to sleep, grandiosity, absence of good judgment, motor hyperactivity, and what can appear to be an expansive flood of fanciful ideas.

Depakote is also used to prevent migraine headaches, but not in the case of pregnant women.

Off-label uses include alcohol dependency, to quell impulsivity and aggressive behavior. Depakote is also sometimes used as an adjunctive medication in the management of schizophrenia or other disorders.

Depakote Alternative Names and Slang

Other trade names for the generic valproate, sodium valproate, or divalproex delayed release, include Depakene, Depakote ER (extended release), Depakote Sprinkles, Stavzor, and Alti-Voproic.

The drug is available in a liquid capsule, tablet or in syrup forms. Depakote Sprinkles are designed so that if a person cannot swallow it in capsule form it can be sprinkled on applesauce or other type of soft food. One capsule of Sprinkles is meant to be used all at once.

Depakote Side Effects

Depakote is often administered as an adjunctive medication, for instance with antipsychotics, SSRI’s, SNRI’s, or other mood stabilizing drugs. It may be difficult to ascertain in such circumstances exactly what drug is causing what side effect; therefore each patient should be monitored carefully in this regard for reactions needing medical attention.

There are some known severe side effects that require careful monitoring while on Depakote, including:

  • HEPATOTOXICITY: liver failure, leading to fatality, which may follow symptoms such as weakness, lethargy, vomiting, anorexia, and facial edema. Especially if a person has a prior history of liver disease, regular physical examinations as well as serum liver tests should be done to monitor the person closely for signs of liver toxicity.
  • BIRTH DEFECTS are linked to taking Depakote during pregnancy, where the infant may develop deformities of the limbs, heart, craniofacial and neural tube defects leading to spina bifida, and others. Birth defects where epileptic mothers took Depakote occur 4 times higher than in babies born to epileptic mothers who took other medications.
  • LOWERED COGNITIVE SCORES AFTER in utero EXPOSURE to DEPAKOTE: has been studied and shown as significantly lower in children born to epileptic mothers taking Depakote compared to children born to mothers taking some other AED or no AED. Since it has not been established if there is a specific period of risk during pregnancy for such birth defects including lowered IQ, the consensus is that women of child-bearing age should not be prescribed Depakote. However, should pregnancy occur while on a prescription of Depakote, the drug should not be withdrawn abruptly due to risk of seizure and other reactions, and possible fatality to the fetus.
  • FATAL PANCREATITIS: in both adult and children are linked to Depakote. Where this condition presents, it can progress rapidly or slowly, but is life-threatening. Some warning signs of pancreatitis can include nausea, vomiting, pain in the abdomen, anorexia, and the patient should be immediately evaluated for hemorrhages and other symptoms of pancreatitis.
  • SUICIDALITY: a two-fold increase in suicidal ideation and behavior in both adults and children. Four suicides occurred within a twelve-week trial.
  • ABNORMAL BLEEDING
  • HYPOTHERMIA
  • OTHER : side effects include rash, somnolence in the elderly, dizziness, indigestion.

 

Depakote Withdrawal Symptoms

Of prime importance is not to abruptly stop using Depakote. Always get medical advice and guidance before stopping an AED.

The most commonly reported withdrawal symptoms are:

  • Return of prior symptoms, i.e., mania, psychoses, seizures
  • Dizziness
  • Tremors
  • Anxiety

Discontinuing/Quitting Depakote

It may become necessary or desired to discontinue Depakote. Except in certain circumstances where continuing the drug is not possible, i.e., life-threatening, Depakote, as with all similar medications, should be gentle tapered off with proper monitoring, support and guidance.

If tapering is done correctly it can be a mild procedure. Done too fast, it can be extremely difficult and can introduce undesirable risks to health.

Depakote FAQs

Below, some information is provided regarding the most frequently asked questions about Depakote, concerning mechanism of action, how it can affect the body adversely, and other things to be aware of.

How Does Depakote Work?

It is thought that Depakote elevates the available amount of GABA, which is a natural brain chemical with a calming effect that helps to calm a person experiencing episodes of mania.

Is Depakote an Antipsychotic?

No, Depakote is classified a first generation antiepileptic, or AED. It is often prescribed along with antipsychotic medications, as well as SSRI’s and SNRI’s in treating certain disorders.

Depakote works largely on increasing GABA permeability, which results in a calming effect on the central nervous system. That is why it is sometime used while helping a patient to withdraw off antipsychotic drugs. The calming effect helps to counterbalance the excitatory dopamine and other neurochemical stimulation that can occur during antipsychotic drug withdrawal.

Is Depakote a Mood Stabilizer?

Yes. Along with lithium and Lamictal, Depakote belongs to a group of drugs referred to as mood stabilizers. These types of drugs are used in the treatment of manic episodes that require sedation and possible hospitalization to help stabilize the person.

Can Depakote Make You Gain Weight?

Yes, Depakote is associated with weight gain in the first three months, and is more pronounced in females compared to males. Noting weight changes before and during treatment is a recommended monitoring practice for epileptic and other patients taking Depakote. (1)

Does Depakote Damage the Liver?

There is significant documented evidence concerning liver damage, toxicity and death related to some patients prescribed Depakote.

What are the Symptoms of Depakote Toxicity?

Depakote toxicity or valproic acid overdose symptoms can include coma, depressed respiratory system, nausea, vomiting, lethargy, chills, hallucinations, confusion, headache, irritability, seizures, somnolence, twitches or jerking motions, and can result in death.

Immediate medical attention without delay is required the moment these Depakote toxicity symptoms emerge.

Can Depakote be Quit ‘Cold Turkey?’

Before quitting Depakote “cold turkey”, seek competent medical advice. The usual procedure would not be to abruptly stop the medication, but to seek help in slowly tapering off the medication.

Even in the case of needing to stop Depakote because of possible fatal side effects, stopping the medication would best be done in an appropriate medical facility where life-saving protocols are available if needed.

Always speak to your doctor before deciding to stop Depakote. If your doctor is resistant to assist despite your desire to quit, it may be pragmatic to consult a more integrative doctor for a second opinion.

Treatment for Depakote Abuse and Addiction?

At ATMC, our goal is to help people safely taper off medications where possible, in a comfortable and compassionate setting. The center is staffed by doctors, nurses, therapists and other care-givers who are well-versed in gentle and effective methods of tapering.

Rather than focus on Depakote addiction or Depakote abuse, the health goals of the individual are of primary importance. Using such protocols as holistic neurotransmitter replacement therapy, toxicity removal, and many other helpful techniques, we can help a person regain optimal health, while at the same reducing the need for prescription drugs, while effectively preventing unwanted withdrawal side effects.

Each person has uniqueness in their make-up, genetic profile, sensitivities, strengths, and personal goals. That is why each client at the center receives a treatment plan tailored to meet those goals specifically.

More information is available on request, and we would welcome further inquiries or requests for more details on our therapies and treatments that could provide you the necessary bridge back to good health.


This content has been reviewed, and approved by a licensed physician.

Dr. John Motl, M.D.

Dr Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor’s of Science degree with a major in biology and minors in chemistry and philosophy. He graduated Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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