Depakote (Divalproex DR)

Description

Divalproex, also recognized as Depakote DR (delayed-release), is a medication used to help control different types of seizures. It is classified as an anticonvulsant and works by calming down the brain to stop seizure activity. Besides treating epilepsy, it is also used to manage mood swings in people with bipolar disorder and to help prevent migraine headaches. Its effectiveness comes from its ability to stabilize mood and the electrical signals in the brain.

Directions

Depakote is typically administered orally in divided doses without crushing or chewing the tablets. The dosage can vary depending on the condition being treated. For example, the initial Depakote dosage for mania associated with bipolar disorder often starts at 750 mg daily, with potential increases to achieve the desired treatment response. For seizures, the dosing starts at 10 to 15 mg/kg/day, with adjustments made as needed. It’s important to take the medication exactly as prescribed by a healthcare provider.

Ingredients

The active ingredient in Depakote is Divalproex Sodium.

Contraindications

Avoid taking or using this medication if any of the following apply:

• Liver disease or severe liver problems
• Certain genetic mitochondrial disorders
• POLG-related disorder in children under 2 years of age
• Known hypersensitivity to Divalproex Sodium or other ingredients in Depakote
• Urea cycle disorders
• Pregnancy when the medication is used to prevent migraine headaches

Cautions

• Before starting treatment with Depakote, make sure to inform your healthcare provider if you have:
• Any existing health conditions
• Any allergies
• A list of all medications you are currently taking
• Whether you are pregnant or breastfeeding

• Depakote can cause serious liver damage, which may lead to death, especially within the first six months of treatment. Early signs include tiredness, weakness, loss of appetite, swelling in the face, nausea, and vomiting. Children under 2 years old, those with pre-existing liver problems, or certain genetic conditions are at higher risk.
• Taking Depakote during pregnancy can cause severe birth defects, including problems with the brain, spine, heart, and face. It can also lower the child’s IQ if taken while pregnant. Women of childbearing age should avoid Depakote unless absolutely necessary, use effective contraception, and consider alternative treatments.
• Life-threatening pancreatitis has been reported in people taking Depakote. Symptoms include severe stomach pain, nausea, vomiting, or loss of appetite. If pancreatitis is diagnosed, Depakote should be stopped immediately.
• Depakote, like other anti-seizure medications, can increase the risk of suicidal thoughts or actions. Patients and caregivers should watch for mood changes, depression, or unusual behaviors and seek medical help if these symptoms appear.
• Depakote can cause high levels of ammonia in the blood, leading to confusion, vomiting, or extreme drowsiness. This condition can occur with or without liver problems. If symptoms arise, stop the medication and consult a doctor immediately.
• Depakote may reduce platelets or affect other blood cells, increasing the risk of bleeding or bruising. Regular blood tests are recommended to monitor for these issues, especially before surgery or during pregnancy.
• Older adults taking Depakote may experience drowsiness, reduced appetite, and dehydration. Dosage adjustments and close monitoring are necessary to avoid these complications.
• Depakote can interact with other medications, including antibiotics and anti-seizure drugs, potentially leading to serious side effects or reduced effectiveness. Inform your doctor of all medications you’re taking to avoid potential Depakote interactions.

Side Effects

The most common side effects of Depakote include headache, dizziness, nausea, and vomiting. You might also experience sleepiness, tremors, or difficulty walking and coordinating movements. Some people report weight changes, loss of appetite, or increased appetite. Other possible effects include stomach pain, flu-like symptoms, hair loss, and blurred or double vision. Talk to your healthcare provider if these side effects persist or bother you.

Depakote can also cause severe liver damage, especially in children under 2 years old or patients with mitochondrial disorders. Signs include fatigue, nausea, loss of appetite, and yellowing of the skin or eyes. Depakote may also harm an unborn baby, increasing the risk of birth defects and developmental issues. Other serious risks include pancreatitis, with symptoms like severe stomach pain and vomiting, and rare suicidal thoughts or behaviors. If you notice any alarming symptoms, contact a healthcare provider immediately.

References

1. Depakote (Divalproex DR) Product Monograph. North Chicago, IL: AbbVie Inc.; 2024.
2. Depakote (Divalproex DR) Drug Label Information. North Chicago, IL: AbbVie Inc.; 2024.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....