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Depakote Withdrawal Help, Symptoms, Side Effects, Treatment Help

This entry was posted in Antipsychotic on by .

Last Updated on March 9, 2021 by Carol Gillette

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Alternative to Meds Editorial Team
Written by Diane Ridaeus Published Sep 13, 2018
Medically Reviewed by Dr John Motl MD

Depakote is usually prescribed during a crisis. Typically, little consideration follows on how to navigate Depakote withdrawal if the drug is no longer required or if debilitating Depakote side effects emerge.

Physicians often prescribe mood stabilizers, like Depakote, as a lifetime treatment for a fixed diagnosis. But is this really true?

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Depakote Withdrawal Symptoms

WARNING: Never abruptly stop using Depakote unless a life-threatening condition requires immediate cessation.2 Always get medical advice and guidance before stopping an antiepileptic drug.

Depakote withdrawal symptoms include:

  • Return of prior symptoms, i.e., mania, psychoses, seizures
  • Relapse of “bipolar” symptoms*
  • Dizziness
  • Tremors
  • Anxiety
  • Anger
  • Mood swings
  • Headaches
  • Depression
  • Insomnia

*Depakote is prescribed for bipolar. According to clinical studies, bipolar is often misdiagnosed where other contributing factors are at play and are not investigated thoroughly.3,4

Discontinuing/Quitting Depakote

getting off depakoteIt may become necessary or desirable to stop Depakote. How to quit Depakote and Depakote alternatives are what we specialize in at Alternative to Meds Center. We have protocols for tapering Depakote and bridging over to natural alternatives to Depakote that can make the withdrawal from Depakote gentle and sustainable. Except in certain circumstances where immediate cessation is required to save the patient’s life, such as liver failure, life-threatening pancreatitis, or other conditions, Depakote should be gently tapered off with proper monitoring, support, and guidance.

The FDA label indicates that where hepatic dysfunction, pancreatitis, toxic levels of ammonia or other life-threatening conditions emerge, Depakote should be immediately stopped.2

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.

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, though bipolar disorder has a high propensity for misdiagnosis.3,4 Manic episodes might be considered a bipolar symptom and are described as distinct periods of abnormally sustained elevated mood and other characteristics including irritability and hostility. Other mania 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 side effects pregnantDepakote is also prescribed to prevent migraine headaches. Depakote is not recommended for pregnant women experiencing migraines due to the risks to the child such as the infant suffering withdrawals at birth, and a high risk for the baby to be born with birth defects or other medical problems.5

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, (valproate), is an FDA-approved anti-seizure (antiepileptic) medication. 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 do one’s own research on such medication as carefully and as thoroughly as possible to make an informed decision. Additional important information on these topics follows.

Notes on Depakote and Bipolar

It is vital to note that Depakote (valproate) 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 below.

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

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-Valproic.

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 types 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, SSRIs, SNRIs, 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 occur 4 times higher where mothers took Depakote compared to other epileptic medications.
  • Lowered cognitive scores after in utero exposure to Depakote:  have 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 and 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 FAQs

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

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 as 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 sometimes 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 bipolar 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. 2

What are the Symptoms of Depakote Toxicity?

Depakote toxicity of 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 Withdrawal be done ‘Cold Turkey?’

Never abruptly stop the medication unless this is required to prevent fatality. 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 immediately available.

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.

Safe Treatment for Depakote Withdrawal

root cause of addictionAt Alternative to Meds Center, 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 caregivers who are well-versed in gentle and effective tapering protocols.

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.

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

1. Verroti A, et al., “Weight gain following treatment with valproic acid: pathogenetic mechanisms and clinical implications,” Abstract revised and published 2011 May [cited 2020 Dec 4]

2. FDA label Depakote (divalproex sodium) 1983 [cited 2020 Dec 4]

3. Shen H, et al., “Analysis of Misdiagnosis of Bipolar Disorder in an Outpatient Setting.” Shanghai Arch Psychiatry April 25 2018 PMID 29736129 [cited 2020 Dec 4]

4. Bowden CL. “Strategies to reduce misdiagnosis of bipolar depression.” Psychiatr Serv. 2001 Jan;52(1):51-5. doi: 10.1176/ PMID: 11141528. [cited 2020 Dec 4]

5. Osterweil N, “Depakote Has High Birth Defects Rate Among Antiepileptics.” MedpageToday [online} August 8 2006 [cited 2020 Dec 4]

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 of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from 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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Depakote Withdrawal Help, Symptoms, Side Effects, Treatment Help
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