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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Dizziness While On Divalproex?

My sister is 74 and has been treated for epilepsy effectively with phenobarbital since her 20 s . About two months ago, she started to jerk mire and went to her neurologist. He kept her on phenobarbital but also added Divalproex sodium starting with one pill for a week, then 2 pills for a few days and then 3 pills per day. She became very dizzy and dis oriented about two days after starting 3 pills per day, ended up in emergency room. The doctor tested her and found she was at toxic level of Divalproex. He reduced that pill to one a day. After about two weeks, she feels much better, but tires easily and says her brain feels mushy...things she used to be able to figure out, she finds much more difficult. She s concerned about that and worried about continuing on the Divalproex , she isn t very confident in her neurologist since he put her on toxic level of this med. Do you have any advice for her?
Wed, 10 Jan 2018
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Addiction Medicine Specialist 's  Response
There is a low safety threshold with most of the anti-epileptics and all of the most effective ones. They work by damping down the brain. This can cause sedation and also dizziness. The difference between the minimally effective level and the incapacitatingly toxic level is quite small and sometimes cannot be acheived.
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What Causes Dizziness While On Divalproex?

There is a low safety threshold with most of the anti-epileptics and all of the most effective ones. They work by damping down the brain. This can cause sedation and also dizziness. The difference between the minimally effective level and the incapacitatingly toxic level is quite small and sometimes cannot be acheived.