Depakote: Uses, Dosage, Side Effects, & More

Is Depakote Available as a Generic Medication?

Depakote is available as a generic medication. It is available as an extended-release tablet taken once per day, known as an ER tablet. It is also available as delayed-release capsules and tablets, usually taken twice daily, known as DR. It is important to ensure you received the correct version of Depakote. Each form is intended to be taken a certain way.¹

Is Depakote a Mood Stabilizer or Antipsychotic?

Depakote is not an antipsychotic. It is known as a mood stabilizer. It is part of the Vaproate family of medications.¹

Are Seroquel & Depakote the Same?

Seroquel, or quetiapine, is a second generation antipsychotic. It is not the same as Depakote.

How Does Depakote Work?

Depakote is a medication that is known as a prodrug. Once taken, it turns into another form, valproate, active in the body. The medication action is not fully understood, but it regulates the levels of chemicals (GABA) in the brain.¹ Abnormal GABA levels have been linked to bipolar disorders in many studies.²

What Is Depakote Used to Treat?

Depakote is FDA-approved to treat seizures and acute mania or mixed episodes associated with bipolar disorder. It is also FDA-approved to prevent migraines and is a prophylaxis treatment. In this article, the focus will be on mental health treatments and uses.¹

Depakote is also used off-label for bipolar depression, maintenance treatment for bipolar disorder, adjunct treatment for schizophrenia, alcohol dependence, and treatment of impulsivity, aggression, and agitation.³ Remember, an off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may benefit someone.

Common Side Effects of Depakote

Taking any medication comes with the risk of side effects, and Depakote is no exception. It is important to discuss with your provider when a side effect is serious enough to call for professional medical help. Most common side effects from Depakote, like changes in weight, changes in sleep, or changes in appetite, will not require immediate medical attention. Everyone is different, and not everyone taking Depakote will experience the same side effects.¹

Common side effects of Depakote include:*

• Nausea or vomiting
• Headache
• Drowsiness or dizziness
• Tremor
• Muscle weakness
• Insomnia
• Hair loss
• Weight gain
• Diarrhea or abdominal pain

*All medications, including Depakote, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Serious Side Effects of Depakote

Depakote is a medication with many serious risks. It is important to take the time to fully understand the risks and know how to recognize each one. Taking Depakote can cause serious organ damage, and proper precautions must be taken.

Before you take Depakote, you should spend time with your healthcare provider to review your health history. This is the time to identify anything that may put you at a higher risk of experiencing serious side effects while taking Depakote. Each of these side effects will require medical attention to treat and help avoid further injury.¹

Serious side effects of Depakote include:*

• Hepatic failure
• Pancreatitis
• Fetal risk
• Hyperammonemic encephalopathy
• Suicidal behavior and ideation
• Bleeding and other hematopoietic disorders
• Hypothermia
• Multiorgan hypersensitivity reactions/DRESS

*All medications, including Depakote, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Depakote Warnings & Precautions

There are many significant warnings that come with taking Depakote, including boxed warnings, that one should be aware of before taking the medication. These precautions are necessary to discuss with your healthcare provider and understand fully before you begin treatment with Depakote. If any of these warnings apply to you, then Depakote may not be the best choice for you. If you still decide to take Depakote, your provider may require more frequent follow-up appointments to closely monitor your health during treatment.

As with severe side effects, if any of the following symptoms or conditions occur, you should seek medical attention right away. These precautions exist because the risk is dangerous and serious harm or death can occur.¹

Avoid taking Depakote if you:

• Have liver disease: Hepatic failure and death (hepatotoxicity) have been reported in patients taking Depakote. It usually happens within the first six months of treatment and is marked by symptoms like weakness, vomiting, and facial swelling.
• Are pregnant: Taking Depakote while pregnant can cause serious fetal harm and defects. Based on data, taking Depakote while pregnant can increase the risk of fetal abnormalities fourfold.
• Are planning to become pregnant: Studies have shown that children born to mothers exposed to Depakote during pregnancy have lowered IQ. Women of childbearing potential should use effective contraception while taking Depakote.
• Have a risk of pancreatitis: Cases of life-threatening pancreatitis have been reported in people taking Depakote. Pancreatitis presents as abdominal pain, nausea, vomiting, and/or anorexia, and any of these symptoms should be taken seriously.
• Have a history of urea cycle disorder: No one with known urea cycle disorders or a familial history of the disorder should take Depakote.
• Have a history of suicidal ideation: All antiepileptic drugs, including Depakote, have increased risk for suicidal thoughts and behavior. Anyone taking Depakote should be monitored for such thoughts, no matter the patient’s age.
• Have a history of bleeding disorders: Taking Depakote can cause a dangerous drop in platelets known as thrombocytopenia. This can lead to dangerous bleeding, especially in those patients with a history of bleeding disorders.

Depakote Dosages for FDA-Approved Treatment

Depakote for treatment of mania and manic episodes in those with bipolar disorder varies between each person. Starting Depakote doses are usually based on a person’s weight. The dose is then increased to achieve the desired control of symptoms. When starting Depakote, it is important to follow your prescriber’s directions exactly. Since this medication is often dosed based on the condition being treated, the exact dosage can change over time and from person to person.¹

Depakote Forms & Strengths

Depakote comes in many forms that can cause confusion if not understood. The medication is available as a delayed-release capsule, an extended-release capsule, and an extended-release tablet. The most common form used to treat mental health diseases is the extended-release tablet. This form of Depakote releases medication slowly over time to help keep steady levels of the drug in the body.

The correct dose is also determined by the drug concentration in your body, so blood tests may be required when starting treatment.¹

Depakote is available in the following forms and strengths:

• 250mg extended-release tablet oral tablet
• 500mg extended-release tablet oral tablet

How Should I Take Depakote?

Depakote ER is taken once daily by mouth. It is important not to crush or chew the tablet since it releases slowly throughout the day in your body. If the tablet is crushed or chewed, it can release too much medication all at once and cause dangerously high levels of medication, followed by dangerously low levels. Some patients report that taking Depakote causes stomach irritation. If this is the case, taking Depakote with food can help.¹

What Happens If I Miss a Dose of Depakote?

If you miss a dose of Depakote, you should take the missed dose as soon as you remember. If it is almost time for your next dose, you should skip the missed dose and continue with your regular dose. Do not double up with doses, as this could lead to dangerous side effects.¹

Can You Overdose on Depakote?

It is possible to overdose from taking too much Depakote, and caution should be taken to only take the medication as prescribed. Symptoms of overdose from Depakote include severe drowsiness, heart block, deep coma, and increased sodium levels (hypernatremia). Overdose from Depakote is serious, and medical attention is required immediately. It has been reported that Naloxone or Narcan can be used to reverse some effects of Depakote overdose. This method should be used with caution, however, as it can also cause seizures in some cases.¹

What Should You Do If You Take Too Much Depakote?

If you take too much Depakote at one time, you should seek help right away. Call 911 or ask someone you are with to call 911. Getting immediate medical help is the most important thing to do.

What to Avoid When Taking Depakote

There are many substances that should be avoided when taking Depakote. Taking certain substances while taking Depakote can cause increased side effects and dangers or cause Depakote not to work as well. It is important to always review your current medications, including supplements and over-the-counter products, with your healthcare team before you start taking Depakote.

Substances you should avoid while taking Depakote include:

• Topiramate: This combination can increase the risk of dangerously high levels of ammonia in the blood and/or hypothermia. You should never take Depakote with topiramate.
• CBD products: Taking Depakote and CBD products can cause liver damage. It is important to not mix the two and reach out to your healthcare provider if you experience any liver-related symptoms.
• Aspirin: Taking aspirin at the same time as Depakote can cause the levels of Depakote to increase significantly in the body. Aspirin is in many over-the-counter products, so it is important to always check with a pharmacist to be safe.
• Contraceptives containing estrogen: Estrogen products can affect how quickly your body processes and removes Depakote. If you take both drugs, your doctor will closely monitor the Depakote dose and adjust as necessary.
• Lamotrigine: Depakote can cause lamotrigine to stay in the body much longer than usual and increases the risk for deadly skin reactions. If the two are taken together, your doctor must adjust the dose of lamotrigine to ensure safety.

How to Get a Prescription for Depakote

Depakote is a prescription-only medication that requires significant monitoring, especially when starting the medication. It is important to work closely with a reputable mental health professional licensed in your state. There are specific symptoms and treatment history requirements that must be met to take Depakote. In addition, many follow-up tests must be conducted when starting Depakote to ensure safe and effective dosing. Having a robust healthcare team that you trust and communicate well with is an important part of Depakote treatment.

How Much Does Depakote Cost?

Depakote is currently available as a generic medication. The copay price with insurance will vary, but even without insurance, it can be an affordable treatment option. Using an online coupon site, you can obtain Divalproex for $20 to $30 dollars a month, depending on your pharmacy of choice.

Questions to Ask Your Healthcare Provider About Depakote

Taking the time to fully understand your Depakote treatment is very important. You should spend significant time with your provider asking questions, understanding what treatment should look like, and what to do if things do not go as planned. It is also an important time to discuss your entire medical history, including familial history.

Your doctor, psychiatrist, and/or therapist should all be made aware of your new medication to support you throughout treatment. If you need to find a new provider, remember that online psychiatry services may be a good option.^1,4

Questions to ask your care team about Depakote include:

• How safe is Depakote?
• How will I know that Depakote is working?
• Will my dose change over time?
• Can I eat with my dose?
• How long will it take for me to adjust to taking Depakote?
• Am I at risk for more serious symptoms if I am already taking other medications?
• What is the best dosage to ensure fewer side effects?
• What symptoms should cause me to seek medical care?
• How often do I need to follow up with visits or monitoring tests?
• What should I do if I think I am pregnant while taking Depakote?
• Discuss all current medications you take.

For Further Reading

• How Is Bipolar Disorder Diagnosed?
• How to Help Someone With Schizophrenia: 10 Tips From a Therapist
• Depression and Bipolar Support Alliance: Find a support group