Depakote For Epilepsy - The Good and the Bad
Depakote might be the epilepsy medication that I know the most about, considering that it’s the one my daughter Rach has used for most of her seizure treatment. But it took me years to learn the various aspects of this medicine, and so I wanted to condense most of the important information into one article for you all today.
It’s part of the series I’m working on which will eventually cover all the seizure medications, because I know how important it is to feel informed about the medicine you’re going to put in your body (or in my case, my child’s body). I’ve already completed one on Keppra if you’re interested in checking that out.
But today, the topic is Depakote. We’ll be discussing what it is, what it does, the various benefits and side effects associated with it, reviews from people who have used it, and my own thoughts about the drug based on mine and my daughter’s experience with it. So let’s jump right in…
General Information About Depakote -
Depakote is the brand name given to the medication “divalproex sodium”. It’s been used in the medical field since 1983, so it’s seen as a very well established drug. Now let’s get into some more specific attributes.
Are there other names for Depakote?
Depakote’s active ingredient is something that turns into valproate, also known as valproic acid, when it enters the body. And that’s why, at times, Depakote may be referred to as valproate or valproic acid. But these names are, of course, a reference to one of the main ingredients of the drug and not the drug itself.
There are other medications which turn into valproate as well, which is where some additional confusion can come into play.
But although these medications have nearly the same effects as Depakote due to the fact they turn into the same thing once they’re inside the body, they are technically separate brands of medication.
I will only be referring to Depakote today; but just for the sake of being thorough, I’ll go ahead and name some of the other drugs which turn into valproic acid. And they are… Depakene and Depacon, plus the generic versions of these two drugs.
What is Depakote used to treat?
Specifically, Depakote is effective in treating absence seizures. But it can also be used to treat other types as well; such as myoclonic seizures, tonic clonic seizures, and focal aware or simple partial seizures.
What are the doses of Depakote?
Depakote comes in several different forms of oral tablets…
A 125-mg tablet which is a salmon pink color
A 250-mg tablet which is a peach color
A 500-mg tablet which is a lavender color
Depakote can also be prescribed in the form of sprinkle capsules which are in doses of 125-mg. The sprinkles are normally given to children or elderly people who may have issues swallowing an entire pill. In fact, when Rach was little and first started on Depakote we used the sprinkles.
The dosage used to treat patients will vary greatly depending on their treatment plan and individual needs. And there’s so much variation that I can’t share a general recommended dosage with you today.
How effective is Depakote?
Overall, Depakote is seen as an effective anti-epileptic drug. And various studies performed on the drug show promising results. But having said that, the effectiveness of Depakote in a treatment plan will depend on the circumstances. Many people see great results, but others might not.
One of the main reasons why this holds true is because different people require different dosages to keep their seizures under control, but because of the side effects associated with high levels of Depakote, sometimes it’s hard to reach the correct dosage without causing other issues.
It’s a fine line between prescribing enough Depakote to control the seizures, while keeping the dosage low enough to not cause other negative effects on the body. And sometimes, the line can’t be found. In this case, the patient and their team will have to evaluate their priorities in the treatment plan.
What are some of the common side effects of Depakote?
Vomiting - Although you should contact the doctor right away if you notice any side effects, vomiting is especially dangerous as it could affect the levels of Depakote in the body which could lead to an increase of seizures. So make sure to call your doctor if you’re struggling with vomiting.
Dizziness - Because of this side effect, as well as a few other side effects listed below, people should be careful doing “dangerous” activities soon after they begin taking Depakote. Purely because they don’t know how the medication will affect them, and something like dizziness could cause them to get hurt.
Tremoring - This particular side effect is known to happen most commonly when the Depakote levels reach their peak in the bloodstream (normally a few hours after taking the dose). Certain things can make it worse, such as anxiety or caffeine.
Hair Loss - About 5-10% of people who take Depakote will experience hair loss. Upon stopping the medication, most people notice the hair growing back. Although it may grow back differently than before, such as having a different texture.
Weight Gain - Around 30-50% of patients who take Depakote will experience weight gain, typically around 15 pounds, although exercise and certain types of dieting could help decrease the amount gained. Women are affected more often than men.
Tiredness - Tiredness may also be accompanied by slower thinking.
Changes In Behavior - This will normally present as depression in adults or irritability in children.
What are some of the rarer and serious side effects of Depakote?
Many of the common side effects aren’t very serious, and can be managed. But this section has to do with side effects that are more rare, but also more dangerous to the patient.
Liver Failure - Liver failure is probably one of the most well known side effects of Depakote, although it only happens rarely. The risk is highest in children under 2 years old, it goes down between the ages of 2 and 10, and by adulthood the chance of liver failure goes down to about 1 in 50,000. Typically if liver failure occurs, it develops within 6 months of starting the medicine.
A Pancreatic Disorder - This potential, yet rare, side effect is less well known but equally as dangerous. It can affect children and adults, and doesn’t always come on as suddenly as liver failure. It can happen even years after starting the medication. But in the worst cases, this pancreatic disorder can cause excessive bleeding and death.
Blood Clots - Patients on Depakote are more likely to have issues with blood clotting.
Suicidal Thoughts - As with most anti-seizure medications, Depakote can potentially lead to depressive and suicidal thoughts. So it’s something to keep in mind, and if the patient starts to feel that way then they should contact help right away.
Note that allergic reactions are possible with Depakote, as with all other medications. So be aware of potential allergies.
What symptoms should you be on the lookout for?
Because of how dangerous the side effects I just named could be, it’s always safest to pay close attention to symptoms you may have while on Depakote. And call your doctor immediately if you start to notice any of them.
Potential Symptoms of Liver Failure - Loss of appetite, vomiting, weakness, sluggishness, facial swelling, and yellowing of the skin or eyes.
Potential Symptoms of Pancreatic Disorder - Loss of appetite, upset stomach, vomiting, and pain in the abdomen.
Potential Symptoms of Blood Clots - Easy bruising, nosebleeds, or other abnormal bleeding.
Potential Symptoms of Suicidal Thoughts - Withdrawal from loved ones, giving away important possessions, depression, preoccupation with morbid subjects, talking or thinking about ending their life.
Who shouldn’t take Depakote?
Anyone already suffering from liver disease or other liver issues should avoid Depakote. So should people who have had allergic reactions to the drug in the past. And finally, some pregnant women may choose to go on a different medication while pregnant as Depakote raises the chances of birth defects in babies.
What People Say About Depakote -
Similarly to most drugs, Depakote has people who swear by it and those that have had horrible experiences with it.
The Good Side - A lot of people are able to find seizure freedom with Depakote when they weren’t able to with other anti-seizure medications. And many of those people never have side effects while using the medicine.
The Middle - There are also people who have found that Depakote improved their seizures but didn’t grant them complete seizure freedom. And in the process, some people do suffer from the side effects presented by Depakote. Although many of them find the side effects worth the decrease in seizures.
The Bad Side - And then, there are people whom Depakote has harmed more than helped. These are the people whose seizures didn’t respond to the medication, and even the people who have suffered from dangerous and potentially deadly side effects of the drug.
But it is important to note that most people never suffer from the rare side effects of Depakote, and Depakote has a fairly good rating that leans far more towards the good and middle ratings than the bad.
My Daughter’s Experience With Depakote -
Now, as I mentioned earlier, my daughter (Rach) has been on Depakote multiple times. So I’d like to talk a bit about our experience with the drug, in both instances, although I’m aware that her reaction to it might not be the same as someone else’s. It’s purely a testimonial from our personal experience.
I’d also like to mention that I’ll be linking other relevant articles that I’ve written, having to do with Rach’s seizure journey, so that you can get a bigger picture of our story and the role that Depakote played in it if you’re interested. But the full story is much too long for this post.
Her First Round Of Depakote -
I talked in detail about the start of Rach’s journey with epilepsy in a previous post, but I’ll summarize here. In 2010, when Rach was just 3 years old, we were told she had epilepsy. Her official diagnosis at the time was Benign Myoclonic Epilepsy with Atonic/Drop Seizures.
Her neurologists swiftly started her on Depakote sprinkles, and after about a month of being on the medication she was seizure free. And throughout the entire time she took Depakote as a small child, she remained seizure free. She did have a few side effects along the way, mostly tiredness, but we were overjoyed that she was no longer seizing.
After a while, her neurologist gave us the green light to start weaning her off the Depakote. He, like us, was hoping that the seizures wouldn’t return; but we were given a warning that it was possible, particularly once she began puberty.
Her Second Round Of Depakote -
Sure enough, when Rach started puberty, her seizures started to come back. She had a tonic clonic in 2020, and was having clusters of myoclonic seizures almost daily. It was a scary time, and we had to restart our seizure journey.
Rach was diagnosed with Juvenile Myoclonic Epilepsy and put on Depakote once again, with a small bit of Ativan prescribed for her when her seizures started to cluster.
As we kept slowly raising her dosage of Depakote, we started to see massive improvement. She began to have less seizures and almost no clusters, then some seizure free days started to peek through, and finally she even had a few seizure free months!
But unfortunately she didn’t stay completely seizure free for long, and even now, she still has a few myoclonic seizures per day. But our journey is still ongoing!
I do want to note that although she’s purely on Depakote as of the time I’m writing this article, at one point recently she was put on Keppra and weaned off the Depakote for a while. But that did not go well, and she responded very negatively to Keppra. She had a lot of side effects and hardly any seizure control. This was even after we had returned her to the full dose of Depakote and a lower dose of Keppra.
So we swiftly began to wean her off of that drug and go back to Depakote only, at which point she started to regain seizure control and feel better again.
Our Experience With Depakote Has Been Good -
As I’ve said, everyone’s case is different. And what has worked for Rach may not work for another epilepsy patient, but overall, Depakote has kept her seizures mostly under control for the entirety of her seizure journey and for that… we are very thankful!
I would love to hear from you about any experiences with Depakote, Keppra, or any other anti-seizure medication.
Sources -
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