HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

How Can Depakote Dosage Be Reduced Due To Side-effects

Posted on Mon, 16 Oct 2017

Question: Hi Doctor

Warm Wishes!

I am Nxxxxxxn DOB 23-Dec-1981 , 92kgs , 6.2feet
I was diagnosed for bi-polar disorder in March 2017 and was made to take the following medicines

Depakote 500mg 1-0-1
Pacetene 2mg 1-0-1
Seranace 5mg 0-0-1

I was 78kgs during March 2017 and active with productive to work
sleeping for 6 hours
Active during the day and with good intelligence and memory

Now(September 2017) I am sleeping for 14 hours
gained weight to 92kgs
Decreased memory , i can sense i take time to respond or do the intellectual work

I am stable with respect to Family and work
I am married with 2kids
I am employed in well known company in XXXXXXX XXXXXXX and work for IT company
Spend time with family kids , able to do normal routine

Hence my humble request is to help me taper the medicines
help me to come out of weight gain , lethargy since Depakote has lot of side effects

During March 2017 i was forced to stay in hospital and take the treatment for the same
I was unwilling to go to hospital and take the treatment but few family members felt based on varied reasons i

need treatment and need consultation and i forced to take the Depakote and other drugs

Again my humble request is that i will maintain the regular routine required for my personal and professional

life so please taper the medicines and let me lead a medication free life.

Many Thanks and Regards
Nxxxxxxn

Answered by Dr. Dr. Ashok Kumar Choudhary (29 minutes later)

Brief Answer:
Pacitane can be decreased

Detailed Answer:
Dear XXXXXXX
Thanks for using HealthcareMagic.

I read your query and understand your concerns.

First of all, I like to inform you that it is almost always better to follow advice of your doctor
as he knows much better about your health condition than any other doctor.

However, since you are having a productive life and symptoms are under control, I'd recommend following changes.

1. Depakote can be taken as 1 gram at bedtime so there are reduced side effects. I understand it causes side effects but without treatment, I feel you will be giving risk for further episodes.

2. Tab Pacitance can be reduced to 2 mg in the morning as it has little effect on stabilization of bipolar disorder.

I hope this helps you.
Feel free to write back to me if you have more questions.

Thanks and regards.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Ashok Kumar Choudhary (3 hours later)

Hi Doctor
Thanks for your reply
There is slight correction
Pacetene prescribed was 2mg 1-0-0

Later on as per your guidelines if I take 1mg of depakote at bed time how can the tapering happen?
I mean to say to taper the medicine completely how should I proceed?
I want to lead a medication free life
In order to substitute for medicines I will maintain healthy routine with regular exercise

Many thanks and best regards
Nxxxxxxn

Answered by Dr. Dr. Ashok Kumar Choudhary (10 hours later)

Brief Answer:
Follow up

Detailed Answer:
Dear Niranja,
Thanks for follow up.

I completely agree that it is not tapering down but the tapering should not be preceded before 9-12 months of treatment. If you taper down without advice of your doctor there is good porbability that you will be having further episodes.

This is common observation among the bip[olar disorder patients that if they stop medications prematurely the further episodes are more severe and longer lasting. This simple observation makes me to believe that you should risk your life in search medication free life.

My recommendation to shift the depakote to night is intended for reduction of side effects associated with it. The reduced side effect will ensure your recovery and better functioning which is key top decide in favour of taper.

I hope this assists you.
If you have more questions I will be glad to answer you further.
If you do not have more questions, please close the discussion and if possible rate the answer for my future patients.

In future if you wish to contact me directly, you can use the below mentioned link:

http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386

Thanks and regards.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar