Talk:Valproate semisodium

Typical dose

What is a typical dose? Sideburnstate 19:37, 16 July 2007 (UTC)

From The Drug Information Handbook, 15th ed., "max recommended dosage is 60 mg per kg per day" for mania, for ER, "max recommended dose 60 mg per kg per day", also for mania. I am not instructing you on how to take this drug, only giving you information. Instructions should always come from a doctor.Jackkoho (talk) 19:22, 28 March 2008 (UTC)

There is no typical dose, per se. Instead most MDs will use the amount of valproic acid present in your blood stream as an indicator of efficacy, and the drug is notoriously fickle in being metabolised. For bipolarity the recommended "sweet spot", if memory serves correct, is between @50 and 110 micrograms/liter, though some MDs will rely merely on how the patient feels. Blood screens, however, remain important to check for liver and pancreatic abnormalities.--Mrdarcey (talk) 22:30, 15 July 2008 (UTC)

Could someone explain, why is divalproex used mainly as mood stabilizer? It's only a form of valproate, its pharmacological active principle is the valproate anion just as with sodium valproate, calcium valproate or valproic acid. It has exactly the same pharmacodynamics as valproic acid or salts thereof. It's quite strange, that it is many times more expensive than generic valproate and that the psychiatric/neurologic indications of these compounds (valproic acid and all of its salts) are not he same. In continental Europe, the indications spectrum of all valproates including divalproex are the same, as well as prices (generics beeing somewhat cheaper than originals like Dépakine/Ergenyl and Convulex).--Spiperon 01:12, 22 October 2006 (UTC)

The separate marketing of divalproex or valproate semisodium (Depakote) for psychiatric conditions and valproate or valproate sodium (Epilim) for neurological conditions by different branches of the same company may be specific to the UK, where Epilim has been available for about 30 years and Depakote for less than ten. The older formulation is out of patent: as there are cheap generic versions, it is not worthwhile for any one company to market it intensively.

According to the British National Formulary or BNF, 52nd edition, Sodium Valproate (Epilim, etc) is indicated for "all forms of epilepsy." The newer (to the UK) drug Valproic Acid (Depakote) is available only as one brand, with no generic competition. and the BNF says it is indicated for "acute mania associated with bipolar disorder." The BNF adds "Sodium valproate has also been used, but it is unlicensed for this indication." These licences apply to marketing rather than to clinical use, but they mean that the older formulation can not be promoted for mania, whereas the newer drug can. When the similarity is pointed out to the Depakote representatives, they may claim a lower incidence of side effects, making it easier to tolerate high dosage, but this seems to refer to gastric irritation. If asked whether Depakote might be preferable for epilepsy as well, they may say that they are not authorised to promote their drug for that purpose. The BNF says, under side effects of Valproic Acid, "See Sodium Valproate."

Perhaps there has been some compromise with the licensing authority, allowing the new more expensive formulation to be licensed for psychiatric use on the understanding that there will be no campaign to change the large population of cheaply treated epileptic patients to the more expensive version. Such a compromise would not be in the public domain, and could not be proven or referenced. Even if there is enough published research evidence to justify the use of the cheaper version in psychiatry, the original manufacturer would not pay for a new product licence for the old drug now that its generic competitors could benefit. NRPanikker 00:51, 16 November 2006 (UTC)

I have always known that most "medications" that relieve depression, psychosis, mania, obsession, attention, in my experience, & belief should not be used in everyday continuation. Depakote ER, in my opinion from experience could be used in much smaller doses, Also, problems associated with severe anger & rage, is very much a problem that should be counseled, not ignored. Most people who are sensitive seek (MHMR), The patients who are legally bound to MHMR, (Probation/Parole) must be heard with patience, and also with sensitivity. Take for instance the use of the injection of Risperdal Consta. This medicine is very dangerous. It shouldn't in my opinion be used with the risky side effects in place of Haldol shots. Also, mental health facilities are coming closer to dangerous ground with lawsuits. Example: (This takes place in a mental health facility) "May I use the phone to call my mother?" "No, you can only use it at..?" "The response to this question goes back to the juvenile ward at a mental health facaility..."where a young person was kept inside the facility "I believe" since his mother put him in. If a person has no rights to choose, then they may be being abused." "One dose of the Haldol injection relieved someone of paranoid schizophrenia immediately." in a mental health facility. Also if medications cause physical damage, then I don't see why an every day dose is helpful?" Also, during childcreation or during and before having sex and creating a child, each person should not be on these types of medicine that are known to have caused birth defects before. Patients on medicine know about these things, and in no other field is more fear and paranoia to express feelings more restricted and discouraged than the mental health medical field. Here is where truely untrained, in some instances, "a group that likes to see someone injected while held down with GOD knows what mixtures of syrums"!!. These people do not understand mental health the same as those who have experienced challenges, and miraculously survived. I believe that the doctors are the ones who need to know the truth about the effects of dangerous experimention. Example: If insulin works and never needs to be changed to a newer insulin, once insulin has been found, then why does the mind need to be ignored and each idea not be heard without threats of fear and loss, (or imprisonment, etc...) The answer: Do not use a medicine continually if it is known to cause severe side effects, then it is obviously similiar to "manslaughter" because inspite of the dangers, doctors still insist on giving the medicine to people who Prince so and so once said and to his shame, because this never worked, that he would haveliked to kill a few million with a pill???. Unanimous

The Reason people take psychiatric medications despite their dangers is that the illnesses themselves are more dangerous than the medications. Take bipolar disorder for example; aproximately 20% of those suffering the illness end up comitting suicide. Bipolar disorder also impacts daily life to such a degree that it is usually worth the possible health risks to take the medication in order to get some relief from the symptoms of the illness. It is usually a very difficult choice that the patient must make. —Preceding unsigned comment added by 71.210.26.166 (talk) 22:05, 22 March 2010 (UTC)

Vivid Dreams

1 to 10% of people taking this drug report abnormal dreams, according to the Drug Information Handbook, 15th ed. Jackkoho (talk) 05:15, 29 March 2008 (UTC)

This medication gives me very vivid dreams, every night. Just thought I'd add that note. Jackkoho 16:41, 6 February 2007 (UTC) Me too. Sideburnstate 14:53, 1 August 2007 (UTC) But n-e-ways.

Role in personality disorders

In Wright's Core Psychiatry (2nd ed, 2005, ISBN: 0 7020 2718 9, page 185), it is mentioned that valproate semisodium may have action in treating personality disorders. Does anyone know any more about this? Ged3000 (talk) 23:39, 17 January 2008 (UTC)

Some doctors are using depakote or sometimes depixol off-label as a "mood stabilizer" for some types of personality disorder. This is usually to prevent very low mood. Dan Beale-Cocks 22:03, 15 March 2008 (UTC)

Weight gain

This side effect of weight gain commonly known by psychiatrists. 1% to 10% report weight gain and increased appetite. Also from the Drug Information Handbook, 15th ed. Jackkoho (talk) 19:20, 28 March 2008 (UTC)