w V w h i t i b V h w a m ( H V o t t m h a www Valp whic help impu takes impr befor Valp has s with and p med (e.g. How Valp of br thro the b med help as sh w.moo proat ch he pful m ulsiv s2-4 roves ore th proat smal hdraw prob dical u post w it w proat rain c ough brain dicati ps bra hown odtre te (d elps d mani ve, irr 4 wee s rac hey a te is ll stu wal, p blem uses t-her work te ca cells a pr ns of ions ain c n bel eatme depak depr ic or ritab eks t cing t act. also udies pani ms of of v rpeti ks an br s. Th roces peo like cells t low: entce kote, ressio mix ble, a to wo thou o FDA s sugg ic, po ange valpro ic ne reak he br ss cal ople w valp to gr enter , diva on, m xed st anxio ork. ughts A-ap gesti ost-t er ma oate eural cycle rain lled k with proat row a r.com valpro mani tates ous, r Peo s and ppro ing it traum anag incl lgia). es of can kindl repe te are and m oex s ia, ag s, wh restle ople d em oved t ma matic geme lude . f moo beco dling . etitiv e hel stren sodiu gitati hich c ess, a who motio for m ay be c stre ent a restl od sw ome Th ve se lpful ngth um, ion a can m and d o resp onal r migr e ben ess d and im less l wing lock he sam eizure for m hen so valp and i mak distr pond react raine nefici disor mpu legs, gs by ked in me c es, w moo o the Befo depr this tree proic irrita ke peo racte d we tivit y e-pre ial in rder, ulsive cert y stab n rep cycles which od sw ey ha ore tr ressi nerv e with acid abilit ople ed. V ell to y so t event n alco bord e con tain k bilizi petiti s hav h is w wings ave s reatm ion a ve ce h few d) is a ty.I e feel Valp it of that tion ohol derli ntrol kind ing t ive m ve be why s. V stron ment: and s ell to w bra a mo It is p agit proat ften they and lism ine p l. Of ds of the e mood een o man Valpr ng er : the stress o shri anch ood s parti tated te usu repo y can seizu and perso ff -lab nerv electr d cyc obser ny se roate conn effec s hav ink b hes. stabi icula d, ually ort th n thin ures. alco onalit bel ve pa rical cles rved eizure e also necti cts o ve ca back (3 ilizer arly y hat it nk . It ohol ty ain firin in e o ions, of aused like 336) r t ng , d ea 722- -7266 W pre val Ho Va do thi as Mo cau for tak ho 6 When even lproa ow s alpro ose. T ick li sprin ost p used r you ken o ours a Ke 1. 2. 3. 4. pr 5. brai nts m ate a shou oate The iquid nkles peop drow u. V on an after ey P Tak Bes We Be roble Avo in ce mood and li uld I can b caps ds or s and ple pr wsine Valpr n em r taki Poi ke w st to e wi aw ems oid ells gr d pro ithiu take be ta sules r con d an refer ess, b roate mpty ing i ints with o ta ill ch ware s, lo if p row oblem um h e it? aken s ten nside XR r to t but it e is b stom it. s h vit ake heck e of ow b preg like ms fo have t ? n 2-3 nd to er an R vers take t is fi better mach tam at n k lab dru blood gnan this or the the m 3 time be la nothe sion; the l ine t r tole h as w mins nigh abs w ug in d co nt o it he e lon most es pe arge. er for ; do n large to tak erate well. (Ce ht;t whil nter ount or ca elps ng-te t ben er da . Ifi rm o not b er po ke in ed wh Va entr take le on ract t, p arry Up Af str co re wi m peop erm. nefits ay or it is h of val brea ortion n the when alpro rum e wi n va tions panc ying pdated fter t reng onnec esult ithin manag ple m Of s on r all a hard lproa ak or n of e mor take oate l m silv with alpr s an crea g he d 1/2 treatm gthen ction is be n the geme mana all p brai at nig d to s ate (i chew their rnin en wi levels ver food roat nd w atitis epat 25/20 ment ned t ns of etter e brai ent. age s psych in gr ght d swa ll (it is w th r dos ng if t ith fo s pea +8 d if te warn s) titis 014 by t: val the ro f the r com in an stress hiatri rowth depe low avail he XR se at that ood, ak in 800 sto ning Co y Chr lproa oots e brai mmun nd be s bet ic m h. endin try t lable R for t nigh work , but n the 0mcg oma gs ( or H ris Ai ate h s and in ce unicat etter tter a medica ng on takin e as a rm). ht, a ks be t can e bloo g fo ach u (liver HIV iken, has d ell. T tion r stre and ation n the ng wi a liqu . as it c etter be od 3 olate upse er viru MD The ess ns, e ith uid, can r -4 e) et us
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
www.moodtreatmentcenter.com
Valproatewhichhelpfulimpulsive, irritable, anxious, restless, and distracted.takes 2improves racing thoughts and emotional reactivitbefore they
Valproatehas small studies suggesting it may be beneficial inwitandmedical uses of valproate include(e.g. post
How
Valproateof brain cellsthrough a process calledthe brains of people with remedications likehelps brain cells to grow and strengthen so they have strongas shown
www.moodtreatmentcenter.com
Valproatewhichhelpfulimpulsive, irritable, anxious, restless, and distracted.takes 2improves racing thoughts and emotional reactivitbefore they
Valproatehas small studies suggesting it may be beneficial inwithdrawal, panic, postand problems of anger management and impulsive control. Offmedical uses of valproate include(e.g. post
How
Valproateof brain cellsthrough a process calledthe brains of people with remedications likehelps brain cells to grow and strengthen so they have strongas shown
www.moodtreatmentcenter.com
Valproatewhich helps depression, mania,helpful manic or mixed states, which can make people feel agitated,impulsive, irritable, anxious, restless, and distracted.takes 2-4 weeks to work.improves racing thoughts and emotional reactivitbefore they
Valproatehas small studies suggesting it may be beneficial in
hdrawal, panic, postproblems of anger management and impulsive control. Off
medical uses of valproate include(e.g. post
How it wo
Valproateof brain cellsthrough a process calledthe brains of people with remedications likehelps brain cells to grow and strengthen so they have strongas shown
www.moodtreatmentcenter.com
Valproate (depakote,helps depression, mania,manic or mixed states, which can make people feel agitated,
impulsive, irritable, anxious, restless, and distracted.4 weeks to work.
improves racing thoughts and emotional reactivitbefore they act.
Valproate is also FDAhas small studies suggesting it may be beneficial in
hdrawal, panic, postproblems of anger management and impulsive control. Off
medical uses of valproate include(e.g. post-herpetic neuralgia)
it works
Valproate can break cycles of mood swings by stabilizingof brain cellsthrough a process calledthe brains of people with remedications likehelps brain cells to grow and strengthen so they have strongas shown below:
www.moodtreatmentcenter.com
depakote,helps depression, mania,manic or mixed states, which can make people feel agitated,
impulsive, irritable, anxious, restless, and distracted.4 weeks to work.
improves racing thoughts and emotional reactivitact.
is also FDAhas small studies suggesting it may be beneficial in
hdrawal, panic, postproblems of anger management and impulsive control. Off
medical uses of valproate includeherpetic neuralgia)
rks
can break cycles of mood swings by stabilizingof brain cells. The brain canthrough a process calledthe brains of people with remedications likehelps brain cells to grow and strengthen so they have strong
below:
www.moodtreatmentcenter.com
depakote,helps depression, mania,manic or mixed states, which can make people feel agitated,
impulsive, irritable, anxious, restless, and distracted.4 weeks to work.
improves racing thoughts and emotional reactivit
is also FDAhas small studies suggesting it may be beneficial in
hdrawal, panic, postproblems of anger management and impulsive control. Off
medical uses of valproate includeherpetic neuralgia)
can break cycles of mood swings by stabilizing. The brain can
through a process calledthe brains of people with remedications like valproatehelps brain cells to grow and strengthen so they have strong
www.moodtreatmentcenter.com
depakote, divalproex sodium,helps depression, mania,manic or mixed states, which can make people feel agitated,
impulsive, irritable, anxious, restless, and distracted.4 weeks to work.
improves racing thoughts and emotional reactivit
is also FDA-approved forhas small studies suggesting it may be beneficial in
hdrawal, panic, post-traumatic stress disorder,problems of anger management and impulsive control. Off
medical uses of valproate includeherpetic neuralgia)
can break cycles of mood swings by stabilizing. The brain can
through a process called kindlingthe brains of people with re
valproatehelps brain cells to grow and strengthen so they have strong
www.moodtreatmentcenter.com
divalproex sodium,helps depression, mania,manic or mixed states, which can make people feel agitated,
impulsive, irritable, anxious, restless, and distracted.4 weeks to work. People who respond well to it often re
improves racing thoughts and emotional reactivit
approved forhas small studies suggesting it may be beneficial in
traumatic stress disorder,problems of anger management and impulsive control. Off
medical uses of valproate includeherpetic neuralgia).
can break cycles of mood swings by stabilizing. The brain can
kindlingthe brains of people with repetitive seizures, which is why many seizure
valproate are helpful for mood swings.helps brain cells to grow and strengthen so they have strong
www.moodtreatmentcenter.com
divalproex sodium,helps depression, mania, agitation and irritabilitymanic or mixed states, which can make people feel agitated,
impulsive, irritable, anxious, restless, and distracted.People who respond well to it often re
improves racing thoughts and emotional reactivit
approved forhas small studies suggesting it may be beneficial in
traumatic stress disorder,problems of anger management and impulsive control. Off
medical uses of valproate include.
can break cycles of mood swings by stabilizing. The brain can become
kindling. The same cycles have been observed inpetitive seizures, which is why many seizure
are helpful for mood swings.helps brain cells to grow and strengthen so they have strong
divalproex sodium,agitation and irritability
manic or mixed states, which can make people feel agitated,impulsive, irritable, anxious, restless, and distracted.
People who respond well to it often reimproves racing thoughts and emotional reactivit
approved for migrainehas small studies suggesting it may be beneficial in
traumatic stress disorder,problems of anger management and impulsive control. Off
restless legs
can break cycles of mood swings by stabilizingbecome
. The same cycles have been observed inpetitive seizures, which is why many seizure
are helpful for mood swings.helps brain cells to grow and strengthen so they have strong
divalproex sodium,agitation and irritability
manic or mixed states, which can make people feel agitated,impulsive, irritable, anxious, restless, and distracted.
People who respond well to it often reimproves racing thoughts and emotional reactivit
migrainehas small studies suggesting it may be beneficial in
traumatic stress disorder,problems of anger management and impulsive control. Off
restless legs
can break cycles of mood swings by stabilizinglocked in repetitive mood cycles
. The same cycles have been observed inpetitive seizures, which is why many seizure
are helpful for mood swings.helps brain cells to grow and strengthen so they have strong
divalproex sodium, valproic acidagitation and irritability
manic or mixed states, which can make people feel agitated,impulsive, irritable, anxious, restless, and distracted.
People who respond well to it often reimproves racing thoughts and emotional reactivit
migrainehas small studies suggesting it may be beneficial in
traumatic stress disorder,problems of anger management and impulsive control. Off
restless legs, certain kinds of nerve pain
can break cycles of mood swings by stabilizinglocked in repetitive mood cycles
. The same cycles have been observed inpetitive seizures, which is why many seizure
are helpful for mood swings.helps brain cells to grow and strengthen so they have strong
Before treatment:depression athis nerve cell to shrink back like atree with few branches.
valproic acidagitation and irritability
manic or mixed states, which can make people feel agitated,impulsive, irritable, anxious, restless, and distracted.
People who respond well to it often reimproves racing thoughts and emotional reactivity so that they can think
migraine-prevention andhas small studies suggesting it may be beneficial in
traumatic stress disorder,problems of anger management and impulsive control. Off
, certain kinds of nerve pain
can break cycles of mood swings by stabilizinglocked in repetitive mood cycles
. The same cycles have been observed inpetitive seizures, which is why many seizure
are helpful for mood swings.helps brain cells to grow and strengthen so they have strong
Before treatment:depression athis nerve cell to shrink back like atree with few branches.
valproic acidagitation and irritability
manic or mixed states, which can make people feel agitated,impulsive, irritable, anxious, restless, and distracted. Valproate
People who respond well to it often rey so that they can think
prevention andhas small studies suggesting it may be beneficial in alcoholism and alcohol
traumatic stress disorder, borderline personalityproblems of anger management and impulsive control. Off
, certain kinds of nerve pain
can break cycles of mood swings by stabilizinglocked in repetitive mood cycles
. The same cycles have been observed inpetitive seizures, which is why many seizure
are helpful for mood swings.helps brain cells to grow and strengthen so they have strong
Before treatment:depression athis nerve cell to shrink back like atree with few branches.
valproic acid) is a mood stabilizeragitation and irritability. It
manic or mixed states, which can make people feel agitated,Valproate
People who respond well to it often rey so that they can think
prevention andalcoholism and alcohol
borderline personalityproblems of anger management and impulsive control. Off
, certain kinds of nerve pain
can break cycles of mood swings by stabilizing the electrical firinglocked in repetitive mood cycles
. The same cycles have been observed inpetitive seizures, which is why many seizure
are helpful for mood swings. Valproatehelps brain cells to grow and strengthen so they have strong
Before treatment:depression and stress have causedthis nerve cell to shrink back like atree with few branches.
a mood stabilizer. It is particularly
manic or mixed states, which can make people feel agitated,Valproate
People who respond well to it often rey so that they can think
prevention andalcoholism and alcohol
borderline personalityproblems of anger management and impulsive control. Off
, certain kinds of nerve pain
the electrical firinglocked in repetitive mood cycles
. The same cycles have been observed inpetitive seizures, which is why many seizure
Valproatehelps brain cells to grow and strengthen so they have stronger connections,
Before treatment: the effects ofnd stress have caused
this nerve cell to shrink back like atree with few branches.
a mood stabilizeris particularly
manic or mixed states, which can make people feel agitated,Valproate usually
People who respond well to it often report that ity so that they can think
prevention and seizures. Italcoholism and alcohol
borderline personalityproblems of anger management and impulsive control. Off-label
, certain kinds of nerve pain
the electrical firinglocked in repetitive mood cycles
. The same cycles have been observed inpetitive seizures, which is why many seizure
Valproateer connections,
the effects ofnd stress have caused
this nerve cell to shrink back like atree with few branches.
a mood stabilizeris particularly
manic or mixed states, which can make people feel agitated,usuallyport that it
y so that they can think
seizures. Italcoholism and alcohol
borderline personalitylabel
, certain kinds of nerve pain
the electrical firinglocked in repetitive mood cycles
. The same cycles have been observed inpetitive seizures, which is why many seizure
Valproate alsoer connections,
the effects ofnd stress have caused
this nerve cell to shrink back like a
(336) 722
a mood stabilizeris particularly
usuallyport that it
y so that they can think
seizures. Italcoholism and alcohol
borderline personality
, certain kinds of nerve pain
the electrical firing
. The same cycles have been observed inpetitive seizures, which is why many seizure
alsoer connections,
the effects ofnd stress have caused
this nerve cell to shrink back like a
(336) 722
a mood stabilizer
port that it
the electrical firing
er connections,
nd stress have causedthis nerve cell to shrink back like a
(336) 722--7266
When brain cells grow like this it helps people manage stress better andprevents mood problems for the longvalproate and lithium have the most benefits on brain growth.
How
Valproatedose. The capsules tend to be large. If it is hard to swathick liquids or consider another form of valproate (it is available as a liquid,as sprinkles and an XR version
Most people prefer to takecausfor you.taken on an empty stomach as well.hours after taking it.
7266
When brain cells grow like this it helps people manage stress better andprevents mood problems for the longvalproate and lithium have the most benefits on brain growth.
How should I take it
Valproatedose. The capsules tend to be large. If it is hard to swathick liquids or consider another form of valproate (it is available as a liquid,as sprinkles and an XR version
Most people prefer to takecause drowsiness, but it is fine to take in the morning if that works betterfor you.taken on an empty stomach as well.hours after taking it.
Key Points
1.
2.
3.
4.
problems, low blood count, pancreatitis)
5.
When brain cells grow like this it helps people manage stress better andprevents mood problems for the longvalproate and lithium have the most benefits on brain growth.
should I take it
Valproatedose. The capsules tend to be large. If it is hard to swathick liquids or consider another form of valproate (it is available as a liquid,as sprinkles and an XR version
Most people prefer to takee drowsiness, but it is fine to take in the morning if that works better
for you. Valproate is better tolerated when taken with food, but can betaken on an empty stomach as well.hours after taking it.
Key Points
1. Take with
2. Best to take at night
3. We will check labs while on valproate
4. Be aware of
problems, low blood count, pancreatitis)
5. Avoid if pregnant or carrying hepatitis C or HIV virus
When brain cells grow like this it helps people manage stress better andprevents mood problems for the longvalproate and lithium have the most benefits on brain growth.
should I take it
can be takendose. The capsules tend to be large. If it is hard to swathick liquids or consider another form of valproate (it is available as a liquid,as sprinkles and an XR version
Most people prefer to takee drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can betaken on an empty stomach as well.hours after taking it.
Key Points
Take with
Best to take at night
We will check labs while on valproate
Be aware of
problems, low blood count, pancreatitis)
Avoid if pregnant or carrying hepatitis C or HIV virus
When brain cells grow like this it helps people manage stress better andprevents mood problems for the longvalproate and lithium have the most benefits on brain growth.
should I take it
can be takendose. The capsules tend to be large. If it is hard to swathick liquids or consider another form of valproate (it is available as a liquid,as sprinkles and an XR version
Most people prefer to takee drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can betaken on an empty stomach as well.hours after taking it.
Key Points
Take with
Best to take at night
We will check labs while on valproate
Be aware of
problems, low blood count, pancreatitis)
Avoid if pregnant or carrying hepatitis C or HIV virus
When brain cells grow like this it helps people manage stress better andprevents mood problems for the longvalproate and lithium have the most benefits on brain growth.
should I take it?
can be takendose. The capsules tend to be large. If it is hard to swathick liquids or consider another form of valproate (it is available as a liquid,as sprinkles and an XR version
Most people prefer to takee drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can betaken on an empty stomach as well.hours after taking it.
Key Points
Take with vitamin
Best to take at night
We will check labs while on valproate
Be aware of
problems, low blood count, pancreatitis)
Avoid if pregnant or carrying hepatitis C or HIV virus
When brain cells grow like this it helps people manage stress better andprevents mood problems for the longvalproate and lithium have the most benefits on brain growth.
?
can be taken 2-3 times per day or all at night depending on thedose. The capsules tend to be large. If it is hard to swathick liquids or consider another form of valproate (it is available as a liquid,as sprinkles and an XR version
Most people prefer to takee drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can betaken on an empty stomach as well.
vitamin
Best to take at night
We will check labs while on valproate
drug interactions and warnings (liver
problems, low blood count, pancreatitis)
Avoid if pregnant or carrying hepatitis C or HIV virus
When brain cells grow like this it helps people manage stress better andprevents mood problems for the longvalproate and lithium have the most benefits on brain growth.
3 times per day or all at night depending on thedose. The capsules tend to be large. If it is hard to swathick liquids or consider another form of valproate (it is available as a liquid,as sprinkles and an XR version; do not break or chew the XR form
Most people prefer to take the larger portion of their dosee drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can betaken on an empty stomach as well.
vitamins (Centrum silver + 800mcg folate)
Best to take at night
We will check labs while on valproate
drug interactions and warnings (liver
problems, low blood count, pancreatitis)
Avoid if pregnant or carrying hepatitis C or HIV virus
When brain cells grow like this it helps people manage stress better andprevents mood problems for the longvalproate and lithium have the most benefits on brain growth.
3 times per day or all at night depending on thedose. The capsules tend to be large. If it is hard to swathick liquids or consider another form of valproate (it is available as a liquid,
; do not break or chew the XR form
the larger portion of their dosee drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can betaken on an empty stomach as well.
s (Centrum silver + 800mcg folate)
Best to take at night; take with food if stomach upset
We will check labs while on valproate
drug interactions and warnings (liver
problems, low blood count, pancreatitis)
Avoid if pregnant or carrying hepatitis C or HIV virus
When brain cells grow like this it helps people manage stress better andprevents mood problems for the long-term. Of all psychiatric medications,valproate and lithium have the most benefits on brain growth.
3 times per day or all at night depending on thedose. The capsules tend to be large. If it is hard to swathick liquids or consider another form of valproate (it is available as a liquid,
; do not break or chew the XR form
the larger portion of their dosee drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can betaken on an empty stomach as well. Valproate levels peak in the blood 3
s (Centrum silver + 800mcg folate)
; take with food if stomach upset
We will check labs while on valproate
drug interactions and warnings (liver
problems, low blood count, pancreatitis)
Avoid if pregnant or carrying hepatitis C or HIV virus
Updated 1/25
After treatment:strengthened the roots andconnections of the brain cell. Theresult is better communicationwithin the brain and better stressmanagement.
When brain cells grow like this it helps people manage stress better andterm. Of all psychiatric medications,
valproate and lithium have the most benefits on brain growth.
3 times per day or all at night depending on thedose. The capsules tend to be large. If it is hard to swathick liquids or consider another form of valproate (it is available as a liquid,
; do not break or chew the XR form
the larger portion of their dosee drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can beValproate levels peak in the blood 3
s (Centrum silver + 800mcg folate)
; take with food if stomach upset
We will check labs while on valproate
drug interactions and warnings (liver
problems, low blood count, pancreatitis)
Avoid if pregnant or carrying hepatitis C or HIV virus
Updated 1/25
After treatment:strengthened the roots andconnections of the brain cell. Theresult is better communicationwithin the brain and better stressmanagement.
When brain cells grow like this it helps people manage stress better andterm. Of all psychiatric medications,
valproate and lithium have the most benefits on brain growth.
3 times per day or all at night depending on thedose. The capsules tend to be large. If it is hard to swathick liquids or consider another form of valproate (it is available as a liquid,
; do not break or chew the XR form
the larger portion of their dosee drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can beValproate levels peak in the blood 3
s (Centrum silver + 800mcg folate)
; take with food if stomach upset
We will check labs while on valproate
drug interactions and warnings (liver
problems, low blood count, pancreatitis)
Avoid if pregnant or carrying hepatitis C or HIV virus
Updated 1/25
After treatment:strengthened the roots andconnections of the brain cell. Theresult is better communicationwithin the brain and better stressmanagement.
When brain cells grow like this it helps people manage stress better andterm. Of all psychiatric medications,
valproate and lithium have the most benefits on brain growth.
3 times per day or all at night depending on thedose. The capsules tend to be large. If it is hard to swathick liquids or consider another form of valproate (it is available as a liquid,
; do not break or chew the XR form
the larger portion of their dosee drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can beValproate levels peak in the blood 3
s (Centrum silver + 800mcg folate)
; take with food if stomach upset
We will check labs while on valproate
drug interactions and warnings (liver
problems, low blood count, pancreatitis)
Avoid if pregnant or carrying hepatitis C or HIV virus
Updated 1/25/2014 by Chris Aiken, MD
After treatment:strengthened the roots andconnections of the brain cell. Theresult is better communicationwithin the brain and better stressmanagement.
When brain cells grow like this it helps people manage stress better andterm. Of all psychiatric medications,
valproate and lithium have the most benefits on brain growth.
3 times per day or all at night depending on thedose. The capsules tend to be large. If it is hard to swallow try taking withthick liquids or consider another form of valproate (it is available as a liquid,
; do not break or chew the XR form
the larger portion of their dosee drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can beValproate levels peak in the blood 3
s (Centrum silver + 800mcg folate)
; take with food if stomach upset
We will check labs while on valproate
drug interactions and warnings (liver
problems, low blood count, pancreatitis)
Avoid if pregnant or carrying hepatitis C or HIV virus
/2014 by Chris Aiken, MD
After treatment: valproatestrengthened the roots andconnections of the brain cell. Theresult is better communicationwithin the brain and better stress
When brain cells grow like this it helps people manage stress better andterm. Of all psychiatric medications,
valproate and lithium have the most benefits on brain growth.
3 times per day or all at night depending on thellow try taking with
thick liquids or consider another form of valproate (it is available as a liquid,; do not break or chew the XR form
the larger portion of their dose at night, as it cane drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can beValproate levels peak in the blood 3
s (Centrum silver + 800mcg folate)
; take with food if stomach upset
drug interactions and warnings (liver
Avoid if pregnant or carrying hepatitis C or HIV virus
/2014 by Chris Aiken, MD
valproatestrengthened the roots andconnections of the brain cell. Theresult is better communicationwithin the brain and better stress
When brain cells grow like this it helps people manage stress better andterm. Of all psychiatric medications,
valproate and lithium have the most benefits on brain growth.
3 times per day or all at night depending on thellow try taking with
thick liquids or consider another form of valproate (it is available as a liquid,; do not break or chew the XR form
at night, as it cane drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can beValproate levels peak in the blood 3
s (Centrum silver + 800mcg folate)
; take with food if stomach upset
drug interactions and warnings (liver
Avoid if pregnant or carrying hepatitis C or HIV virus
/2014 by Chris Aiken, MD
valproate hasstrengthened the roots andconnections of the brain cell. Theresult is better communicationwithin the brain and better stress
When brain cells grow like this it helps people manage stress better andterm. Of all psychiatric medications,
3 times per day or all at night depending on thellow try taking with
thick liquids or consider another form of valproate (it is available as a liquid,; do not break or chew the XR form).
at night, as it cane drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can beValproate levels peak in the blood 3
s (Centrum silver + 800mcg folate)
; take with food if stomach upset
drug interactions and warnings (liver
Avoid if pregnant or carrying hepatitis C or HIV virus
/2014 by Chris Aiken, MD
hasstrengthened the roots andconnections of the brain cell. Theresult is better communicationwithin the brain and better stress
When brain cells grow like this it helps people manage stress better andterm. Of all psychiatric medications,
3 times per day or all at night depending on thellow try taking with
thick liquids or consider another form of valproate (it is available as a liquid,.
at night, as it cane drowsiness, but it is fine to take in the morning if that works better
Valproate is better tolerated when taken with food, but can beValproate levels peak in the blood 3
s (Centrum silver + 800mcg folate)
; take with food if stomach upset
drug interactions and warnings (liver
Avoid if pregnant or carrying hepatitis C or HIV virus
/2014 by Chris Aiken, MD
connections of the brain cell. Theresult is better communicationwithin the brain and better stress
term. Of all psychiatric medications,
3 times per day or all at night depending on thellow try taking with
thick liquids or consider another form of valproate (it is available as a liquid,
at night, as it cane drowsiness, but it is fine to take in the morning if that works better
Valproate levels peak in the blood 3-4
s (Centrum silver + 800mcg folate)
; take with food if stomach upset
Avoid if pregnant or carrying hepatitis C or HIV virus
www.moodtreatmentcenter.com (336) 722-7266 Updated 1/25/2014 by Chris Aiken, MD
Valproate tends to work better and have fewer side effects if taken with amultivitamin that contains folate (at least 1mg; also called folic acid),selenium, zinc, B6 and B12. This can be achieved by taking certainmultivitamins (e.g. Centrum Silver, Puritan’s Pride one-a-day) withadditional folate (usually 800mcg; read the multivitamin label to determinehow much).
Valproate is one medicine where we can scientifically determine youroptimal dose by measuring the level in your blood. The ideal level rangesfrom 50-125, and the higher range (above 90) is often necessary to treatactive mania.
Valproate is stabilized in its capsule by binding it to a salt. This can bedone in different ways so it is available in three forms: divalproex sodium,valproate sodium, and valproic acid. Of these, the divalproex sodium formtends to be the best tolerated.
It is also available in a delayed release (XR) capsule which is easier on thestomach and may have less weight gain. If you are taking another form andswitch to the XR, you will need to raise your dose by 10-20% to achieve thesame blood levels (because some of the XR does not get absorbed).
What if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almosttime for the next dose, skip the missed dose and continue your regulardosing schedule. Do not take a double dose to make up for a missed one.Do not take more than the prescribed daily amount in 24 hours.
How long do I need to take it?
Whether or not you can safely come off valproate depends on yourdiagnosis and which other medications you are taking. Most people withbipolar disorder need to stay on at least one mood stabilizer for the longterm in order to prevent mood swings. If valproate helped, it is best to stay
on it for at least 6 months before considering going off it. That gives thebrain time to build up habits of stability.
What happens if I stop it?
Valproate is not addictive and does not cause withdrawal symptoms. Youmay read that stopping valproate can cause seizures; this warning onlyapplies to people who take it for seizures. If you plan to come off valproate,it is best to do so slowly as that will lower the chance of sudden moodswings returning.
Checking labs
You will need to have labs checked a 1-2 times per year while on valproateto monitor the level of the medicine and ensure it is not impacting your liveror blood count. If you take the medicine during the day, make sure to getthe labs drawn before taking your daytime dose.
Side effects
Common side effects (many of these improve by lowering the dose):Nausea (10-30%), vomiting (5-20%), indigestion (5%), diarrhea (5%),stomach pain (5-15%), headache (10%), fatigue (5-20%), tremor (10-20%),sensory changes (10%), dizziness (5%), double vision (5%), blurred vision(5%), hair loss (5%), weight gain (5-10%), poor concentration (5%),menstrual abnormalities.
Valproate may increase bleeding and should not be taken with aspirin.
Rare but serious side effects:
Liver failure: this is a rare side effect of valproate. If it occurs, it is mostlikely during the first 6 months. It is also it is more common in childrenand those with neurologic problems such as mental retardation andsevere epilepsy. To reduce this risk, we will monitor your liver enzymeswhile taking valproate. Rarely, valproate will impact only the liver’sability to detoxify ammonia, causing symptoms of lethargy andconfusion.
www.moodtreatmentcenter.com (336) 722-7266 Updated 1/25/2014 by Chris Aiken, MD
Pancreatitis: rare cases of severe pancreatitis have been reported (rateapproximately 1 in 1,000).
Thrombocytopenia (drops in platelet count): very rarely, valproate can causeseriously impair the bloods ability to clot.
Polycystic Ovarian Disease: although valproate has been rarely associatedwith this condition in women, it is not yet clear that it causes it. Thesymptoms include irregular or no menstrual periods, facial and otherhair growth, acne, changes in body shape and obesity.
Call me (336-722-7266) if you have… Flu-like feelings, extreme fatigue,confusion, loss of consciousness, yellowing of the skin or eyes, swelling of the face,vomiting, no appetite, belly pain, increased or unusual bleeding.
An allergic reaction is possible with any medication. Symptoms include thefollowing; stop the medication and call me if these occur: Pounding heartbeat;swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lowerlegs; hoarseness; difficulty swallowing or breathing; hives; rash.
Pregnancy: You should call me and plan to come off valproate if you areplanning to become pregnant. There are many safer options for managingbipolar during pregnancy that we can talk about. Serious birth defects havebeen caused by taking valproate while pregnant (e.g. neurotube defects,where the spinal cord does not close), especially if taken during the firsttrimester.
Women of childbearing age should take vitamins with valproate (see page 1“How should I take it?”) to reduce the risk of these defects in the event ofunexpected pregnancy while on valproate.
Valproate comes out in breast milk and should be avoided while breastfeeding. Valproate will not affect future pregnancies after you stop taking itand will not affect fertility in men.
For people who are HIV+ or hepatitis C+: there is a small risk that valproatecan increase the replication of the virus. Talk to us about other options for
bipolar (e.g. lithium, N-acetylcysteine) which have some evidence forreducing the HIV infection.
For people with thyroid disease: there are rare reports of valproate alteringthyroid levels.
Interactions (partial list)
Recreational drugs: Alcohol can increase the dizziness and dyscoordinationof valproate. Alcohol and recreational drugs can also prevent valproatefrom working.
Valproate can lower levels of:Oxcarbazepine (Trileptal, by 18%), amitriptyline (Elavil), nortriptyline,calcium-channel blockers (verapamil, femlodipine; by 30%).
Valproate can raise levels of:Diazepam (Valium), lamotrigine (also increase risk of lamotrigine-inducedrashes), ethosuximide, phenobarbital, phenytoin, tolbutamide, warfarin(Coumadin), zidovudine.
Drugs that can lower valproate levels:Phenytoin, carbamazepine (by 20%), phenobarbital, meropenem, rifampin
Drugs that can raise valproate levels:Aspirin (valproate also can increase the risk of bleeding with aspirin),felbamate (by 30-50%)
Drugs that my increase the risk of liver problems with valproate:High-dose or long-term acetaminophen (Tylenol), disulfiram (Antabuse),naltrexone, certain seizure medications, plicamycin (Mithracin).
Other drugs that may interact with valproate:Acetaminophen (Tylenol: long term or high-dose use may increase risk ofliver problems), amiodarone (Cordarone), anabolic steroids (nandrolone,Anabolin, oxandrolone, Anavar, oxymetholone, Anadrol, stanozolol,Winstrol), androgens (male hormones), anticoagulants (heparin,
www.moodtreatmentcenter.com (336) 722-7266 Updated 1/25/2014 by Chris Aiken, MD
coumadin), carmustine (BiCNU), dantrolene (Dantrium), daunorubicin(Cerubidine), estrogens (female hormones), etretinate (Tegison), gold salts(medicine for arthritis), mercaptopurine (Purinethol), methotrexate(Mexate), methyldopa (Aldomet), phenothiazines (acetophenazine, Tindal,chlorpromazine, Thorazine, fluphenazine, Prolixin, mesoridazine Serentil,perphenazine, Trilafon, prochlorperazine, Compazine, promazine, Sparine,promethazine, Phenergan, thioridazine, Mellaril, trifluoperazine, Stelazine,triflupromazine, Vesprin, trimeprazine), Temaril, carbenicillin by injection(Geopen), dipyridamole (Persantine), pentoxifylline (Trental),sulfinpyrazone (Anturane), ticarcillin (Ticar), mefloquine.
Overdose
An overdose of valproate should be assessed and treated in the emergencyroom. A toxic overdose can cause extreme fatigue, slowing or failure of theheart, changes in consciousness or coma.
How to store and dispose of medication
Keep out of the reach of children. Store away from heat, direct light and damp places. To safely dispose of unwanted pills: Do not pour in the toilet or sink (it
will enter the water supply). To prevent children or pets from eating it,mix unwanted pills in a bag with a little water and inedible trash (such ascoffee grounds or kitty litter) and throw in the trash.
Quick facts
Brand namesDepakote, Depakote-ER, Depakene (liquid), StavzorGenerics: Divalproex sodium, valproic acid, valproate
Dose range
Dosing is based on your blood level, which can rangefrom 50-125 mcg/ml.
A rapid starting dose can be estimated based on your
body size (weight in lbs * 9):
120 lb: 1,000mg/day; 150 lb: 1,250mg/day180 lb: 1,500mg/day; 200 lb: 1,750mg/day250 lb: 2,250mg/day; 300 lb: 2,750mg/day
The maximum dose can also be estimated as weight inpounds times 27.2:
120 lb: 3,250mg/day; 150 lb: 4,000mg/day180 lb: 4,900mg/day; 200 lb: 5,450mg/day250 lb: 6,800mg/day; 300 lb: 8,150mg/day
(above doses may need to be raised by 10-20% if takingthe ER form)
Sizes
> Tabs: 125, 250m 500mg (generic)> ER*: 250, 500mg (generic)> Sprinkles: 125mg (sprinkle on food)> Liquid: 50mg/ml> IV or injection (depacon)
*do not crush or chew XR tabs
Release date 1/28/1978
FDA-approvalBipolar disorder, epilepsy (seizures), migraine-prevention
Related Documents
