Depakote

What is it?

An antidepressant preparation which is a GAGA potentiator (GABA is a neurotransmitter present in the brain). Available as oval, enteric- coated tablets in two different strengths; orange tablets contain 250mg of valproic acid as semisodium valproate and lilac tablets contain 500mg.

Medical Uses

Immediate, acute treatment of manic outbursts arising as a result of bipolar disorders.

Dosage

750mg in 2 to 3 divided doses each day at first, then titrated to increase to the most effective dose. The usual maintenance dose is in the order of 1 to 2g each day.

Special Care

Pregnancy, breastfeeding, SLE, kidney disease, neurological disorders, diabetes, patients subject to fits. Blood tests must be carried out before beginning therapy and when there is bleeding or bruising and prior to surgery. Also, liver function tests are required before treatment begins and during the first half year of therapy.

Avoid Use

Children, liver disease or severe impairment of liver function, pancreatitis, porphyria (an inherited disorder involving increased abnormal production of porphyrins).

Possible Drug and Food Interactions

Coumarin anticoagulants, antidepressants, phenobarbitone, carbapenem antibiotics, lamotrigine, felbamate, antipsychotic drugs, primidone, salicylates, zidovudine, MAOIs, erythromycin, carbamazepine, chlorestyramine, benzodiazepines, warfarin, phenytoin, cimetidine, mefloquine.

Known Side Effects

Gastrointestinal upset, erythema multiforme (an allergic syndrome in which there are eruptions on the skin and mucous membranes), Stevens-Johnson syndrome (an extreme form of erythema multiforme), liver failure, pancreatitis, gain in weight, fine postural tremor, sleepiness, neurological effects, rashes, toxic necrolysis of the skin, absence of menstruation in women, loss of hair, thrombocytopenia (a bleeding disorder involving the platelets), inflammation of blood vessels, reversible Fanconi's syndrome.