Bookmark S4H
Refer S4H
Chat
Forum
Sponsors
Search
ADD & ADHD
Autism
Anxiety/Panic
Bipolar
Depression
Domestic Abuse
G A D
O C D
P T S D
Phobias
Schizophrenia
Medications
Testimonials
Crisis #'s
M H News
Comments
Technical Help
F A Q
Awards
Links
Privacy Policy
User Agreement
Disclaimer
Write Us:
Support4Hope
PO Box 184
Deer Lodge, TN
37726

Mental Health Medications Index & Information

Home Anti-Anxiety To find information on idividual medications, select them from the list below. If you don't find the medication you are looking for in our list, send in your request using our Comments Form, and we will try to add it.
Medications Introduction Anti-Depression
Questions For Your Doctor Anti-Manic
Symptom Relief Anti-Psychotic
If menu doesn't work because of your browser,
Click Here
Anti-Convulsants Mood Stabilizers

Mood Stabilizers as Medications divalproex, Depakote

Mood stabilizer: divalproex, Depakote

Generic Name: divalproex
Brand Name(s): Depakote
Common Use: Mood stabilizer

Divalproex sodium has anticonvulsant properties, and is chemically related to valproic acid. Although its mechanism of action has not yet been established, it has been suggested that its activity is related to increased brain levels of gamma-aminobutyric acid (GABA). The effect on the neuronal membrane is unknown. It dissociates into valproic acid in the gastrointestinal tract.

Acute Mania:
Divalproex is indicated in the treatment of the manic episodes associated with bipolar disorder (DSM-III-R). The effectiveness of divalproex in long-term use, that is for more than 3 weeks, has not been systematically evaluated in controlled trials. Dilvalproex is not indicated for use as a mood stabilizer in patients under 18 years of age.

Contraindications
Patients with hepatic disease or significant dysfunction. Hypersensitivity to the drug.

Adverse Side Effects

Gastrointestinal:
Nausea, vomiting and indigestion are the most commonly reported side effects at the initiation of therapy. These effects are usually transient and rarely require discontinuation of therapy. Diarrhea, abdominal cramps and constipation have also been reported. Anorexia with some weight loss and increased appetite with some weight gain have also been seen.

CNS:
Sedative effects have been noted in patients receiving valproic acid alone but are found most often in patients on combination therapy. Sedation usually disappears upon reduction of other antiepileptic medication. Ataxia, headache, nystagmus, diplopia, asterixis, "spots before the eyes", tremor (may be dose-related), dysarthria, dizziness, and incoordination have rarely been noted. Rare cases of coma have been reported in patients receiving valproic acid alone or in conjunction with phenobarbital.

Dermatologic:
Transient increases in hair loss have been observed. Skin rash, photosensitivity, generalized pruritus, erythema multiforms, Stevens-Johnson syndrome and petechiae have rarely been noted.

Endocrine:
There have been reports of irregular menses and secondary amenorrhea, breast enlargement, galactorrhea and parotid gland swelling in patients receiving valproic acid. Abnormal thyroid function tests have been reported (see Precautions).

Psychiatric:
Emotional upset, depression, psychosis, aggression, hyperactivity and behavioral deterioration have been reported.

Musculoskeletal:
Weakness has been reported.

Special Senses:
Hearing loss, either reversible or irreversible, has been reported however, a cause and effect relationship has not been established.

Other:
Edema of extremities has been reported.

Bipolar Disorder:
The incidence of adverse events has been ascertained based on data from 2 short-term (21 day) placebo-controlled clinical trials of divalproex in the treatment of acute mania, and from 2 long-term (up to 3 years) retrospective open trials.

Most Commonly Observed:
During the short-term placebo-controlled trials, the 6 most commonly reported adverse events in patients (N=89) exposed to divalproex were nausea (22%), headache (21%), somnolence (19%), pain (15%), vomiting (12%), and dizziness (12%).
In the long-term retrospective trials (634 patients exposed to divalproex), the 6 most commonly reported adverse events were somnolence (31%), tremor (29%), headache (24%), asthenia (23%), diarrhea (22%) and nausea (20%).

Associated With Discontinuation of Treatment:
In the placebo-controlled trials, adverse events which resulted in valproate discontinuation in at least 1% of patients were nausea (4%) abdominal pain (3%), somnolence (2%) and rash (2%). In the long-term retrospective trials, adverse events which resulted in valproate discontinuation in at least 1% of patients were alopecia (2.4%), somnolence (1.9%), nausea (1.7%) and tremor (1.4%). The time to onset of these events was generally within the first 2 months of initial exposure to valproate. A notable exception was alopecia, which was first experienced after 3 to 6 months of exposure by 8 of the 15 patients who discontinued valproate in response to the event.

Overdose

Naloxone has been reported to reverse the CNS depressant effects of valproic acid overdosage. Because naloxone could theoretically also reverse the antiepileptic effects of divalproex, it should be used with caution in patients with epilepsy.
Since divalproex tablets are enteric-coated, the benefit of gastric ravage or emesis will vary with the time since ingestion. General supportive measures should be applied with particular attention to the prevention of hypovolemia and the maintenance of adequate urinary output.

BACK TO THE LIST

Relative Links

 

 

User Agreement | Disclaimer | Privacy Policy | Schizophrenia | Autism | PTSD | ADD & ADHD
Domestic Abuse | Depression | Bipolar | GAD | OCD | Medications | Home | Anxiety/Panic | Phobias


Copyright © 1999 -
Support4Hope Inc. All Rights Reserved
Quality Web Design and Hosting where the customer remains 1st Priority