Depakote ER for depression

Dear Ask The Doctor: I was recently diagnosed as Bi Polar Manic Depression. Beside the 20 mg of Lexapro that I was already taken, I was given 500 mg of Depakote ER to help with the Bi Polar part. I have been taking the Depakote for about 10 days now. With the side effects that I am having, including sleeping all day, is it safe for me to stop taking the Depakote ER and ask my doctor for a different drug? I also take OTC Melatonin to help me fall asleep at night.

Dear Brent: The side effects you mentioned are common in the first 2 weeks of use.

I would suggest waiting till at least the 14 day mark before attempting another medication recommend by your doctor.  I also find it is sometimes helpful to maintain the dose and change the time of day the medication is taken.  This simple change can alleviate the side effects.  Prior to doing so, you should discuss this with your pharmacist to ensure there are no drug interactions with other medications you are taking at the same time.

Lastly, dosing is important when taking medications for mood disorders. a lesser dose may be a more appropriate starting point and then gradually increasing it to the desired dose.  ER (extended release) tablets can not be safely cut in half like other tablets and a new prescription for the lower dose may be required.

Similarly, when stopping medications for mood disorders, it is not a good idea to stop abruptly. Withdrawal side effects can occur. It is best to taper the dose over a period of time as recommended by your doctor.