Depakote for Bipolar Disorder

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

This article discusses what you should know about Depakote before taking it to treat bipolar disorder. It covers how Depakote levels are monitored, how this medication is used, and potential side effects you might experience.

Depakote Levels, Uses, and Forms

Depakote is approved by the U.S. Food and Drug Administration (FDA) for the treatment of mania, with or without psychotic features. It's also approved to prevent migraines and treat epilepsy and is frequently prescribed for people with hypomania.

This drug is available in a variety of forms and dosages, including capsules, sprinkles, extended-release tablets, delayed-release tablets, and syrup.

How to Take Depakote

The daily dose typically ranges between 1,000 milligrams and 3,500 milligrams per day. Depakote is usually taken one to three times per day, depending on your dosage and directions from your doctor. It can be taken with or without food. 

Your doctor may start you on a low dose and gradually adjust the amount you take over a period of several weeks. 

If you miss a dose of Depakote, take it as soon as you remember unless it is close to the time you should take your next dose. In that case, skip the missed dose and take your next dose as usual. 

Depakote Side Effects

The most common side effects of Depakote include:​

• Nausea
• Somnolence (drowsiness)
• Dizziness
• Vomiting
• Weakness
• Abdominal pain
• Dyspepsia (indigestion)
• Rash

Let your doctor know if these side effects are severe or if they aren't going away. In such cases, your doctor may adjust your dose or switch you to another medication.

Depakote Warnings

There are a number of warnings associated with Depakote:

• There has been some correlation of Depakote with liver problems, so your doctor may check your liver function with blood tests.
• In elderly patients, dosage adjustment and close monitoring of potential side effects are important.
• Depakote can cause damage to your pancreas, and if this is diagnosed, it 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).

There is some risk of increased suicidal ideation and behavior in people who are being treated with this category of anticonvulsants.

Depakote and Pregnancy

Depakote should only be used with extreme caution if you're pregnant. Birth defects, such as spina bifida, and developmental problems, such as lowered IQ, have been reported. Talk to your doctor about your medication options if you're pregnant or are considering getting pregnant.

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 your child, ensure your doctor knows you're taking Depakote.

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. The Lamictal dosage should be reduced when it's co-administered with Depakote.