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Sugges Depakote Dosage For Labile Mood

Posted on Thu, 10 Apr 2014

Question: Additional information: Due to my labile moods my psychiatrist began Depakote last Sept, current dose is 500 mgs BID

Answered by Dr. Ashish Mittal (4 hours later)

Brief Answer: Depakote stabilises mood. Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 56 year old female • Known case of Labile mood, on Depakote 1000mg per day. • History of Medical problems: HTN, hypothyroidism, chronic anemia and osteoarthritis (On treatment). Surgical Problems: appendectomy, right ganglion cyst removal, right rotator cuff repair. Depakote contain Divalproex. Its usual dose is 20mg/kg per day. This medicine also called as mood stabilizer and given for for long term to stabilize mood in patient suffering from labile mood. It prevent both depressive and anger phase of mood. Even if patient develops mood fluctuation on medicine, it is less severe and last for short period. If I look in your medical history: anemia and hypothyroidism increase mood lability, so keep them under control by regular monitoring and treatment (you already on treatment). If you need any specific information, let me know, so that I can help you better. Wish you good health. Regards,

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

Follow up: Dr. Ashish Mittal (46 minutes later)

I'm unsure if you received the full history, all that printed was the additional information. I have a 20 year history of depression, anxiety and borderline personality disorder with persistent suicidal ideation with numerous plans but no intent. Other sxs include insomnia/hypersomnia, crying jags, increasing isolation and irritability, dissociative episodes lasting anywhere from a few minutes to over 24 hours during which I go on spending sprees for thousands of dollars. There have been several suicide attempts, the last in April of 2013 when I took an overdose of quetiapine, and 3 psychiatric hospitalizations in the last 16 months. I'm currently under the care of a psychologist that I see weekly, in group therapy weekly, and see my psychiatrist as needed based on my mental status, minimally of every 4 months. At this point I'm not sure what else, if anything, can be done to alleviate my distress. My insurance is limited to the VA system (service connected disability) and my financial resources are limited but would welcome a 2nd opinion. Is there anything else that my doctors or I haven't thought of?

Answered by Dr. Ashish Mittal (3 hours later)

Brief Answer: Hi Detailed Answer: Hello again, Thanks for follow up. With further information it is clear that you are having chronic anxiety-depressive symptoms. In between you had episode of excessive spending, which frequently happen in elevated mood, in person with mood fluctuation. In my opinion Depakote is a good medicine for you as it stabilize mood and helpful in borderline personality. Same time continue sessions with your psychologist as combined treatment (counseling+medicines) is best treatment option for your problem. Please accept my answer & give feedback in case there is no further query and you found reply helpful. In case of doubt, I am here to help you. Wish you good health. Regards

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