Depakote ER (Divalproex ER)

Indications

Depakote ER (extended release) is a prescription medication used to treat acute manic or mixed episodes associated with bipolar disorder. It contains the active ingredient divalproex sodium and is designed to slowly release the medication into the body over time. Depakote works by increasing the levels of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain. This helps to stabilize the mood and reduce the risk of seizures.

Divalproex is an anti-epileptic drug that has various indications including the acute treatment of manic or mixed episodes associated with bipolar disorder, with or without psychotic features. It can also be used for monotherapy and adjunctive therapy of complex partial seizures and simple and complex absence seizures. It can also be used as adjunctive therapy in patients with multiple seizure types, which include absence seizures. In addition to these indications, Depakote ER can be used for migraine headache prophylaxis.

Uses and Dosage

Depakote ER is available in tablet form and is taken orally once a day, unless otherwise directed by a doctor. The tablets should be swallowed whole and not crushed or chewed to avoid releasing all the medication at once, which can increase side effects. Patients may take Depakote ER with food to prevent stomach upset.

The recommended dosage of Depakote ER (Divalproex ER) depends on several factors such as age, weight, medical condition, response to treatment, and other medications the patient may be taking. The recommended initial dose for Depakote ER tablets is usually 25 mg/kg/day given once daily, which can be increased gradually.

Side Effects

Common Side Effects of Depakote ER (Divalproex ER):

• Constipation
• Cough
• Diarrhea
• Dizziness
• Double vision
• Drowsiness
• Fever
• Flu symptoms
• Hair loss
• Headache
• Nausea
• Rash
• Sore throat
• Vomiting
• Weakness
• Wheezing

Serious Side Effects of Depakote ER (Divalproex ER):

• Back pain
• Blurred vision
• Bruising or bleeding
• Changes in weight or appetite
• Change in your mental state
• Cold feeling
• Confusion
• Memory problems
• Mood changes
• Easy bruising, unusual bleeding (nose, mouth, or gums)
• Fever, swollen glands, mouth sores
• Purple or red pinpoint spots under your skin
• Severe drowsiness
• Tiredness
• Vomiting
• Worsening seizures
• Stomach pain
• Swelling in your hands or feet
• Tremors
• Trouble breathing
• Trouble sleeping
• Unusual eye movements
• Problems with walking or coordination

Form and Strength

Depakote ER (Divalproex ER) is available in the following forms and strength:

Depakote ER: Extended-Release Tablet

• 250 mg
• 500 mg

Depakote ER: Extended-Release Tablet

• 125 mg
• 250 mg
• 500 mg
• 750 mg
• 1000 mg

Caution

• Patients are advised to limit or avoid alcohol consumption while taking Depakote ER, as it may increase the risk of liver damage and other side effects.
• Depakote ER can cause liver damage, especially in young children under the age of two, people with liver disease, and patients taking other medications that can harm the liver. Liver function tests should be performed before starting Depakote ER and monitored regularly throughout the treatment.
• Depakote ER can cause inflammation of the pancreas, which can be life-threatening. Patients should inform their healthcare provider immediately if they experience symptoms such as severe stomach pain, nausea, vomiting, or loss of appetite.
• Depakote ER can increase the risk of bleeding disorders, especially in patients with a history of bleeding problems or taking medications that affect blood clotting. Patients should inform their healthcare provider if they experience symptoms such as unexplained bruising or bleeding.
• Depakote ER may cause drowsiness or dizziness, which can impair cognitive and motor function. Patients should avoid driving or operating heavy machinery until they know how the medication affects them.
• Depakote ER may increase the risk of suicidal thoughts or behaviors, particularly in children, teenagers, and young adults. Patients should be monitored closely for signs of depression, suicidal thoughts, or behaviors, and report them to their healthcare provider immediately.
• Depakote ER can cause elevated levels of ammonia in the blood, which can lead to encephalopathy (a brain disorder). This is particularly a concern for patients with underlying liver disease.
• Depakote ER can cause a decrease in the number of platelets in the blood, which can increase the risk of bleeding. Patients should be monitored for symptoms such as easy bruising or bleeding.
• Depakote ER may cause allergic reactions, including skin rash, hives, and swelling of the face, lips, tongue, or throat. Patients should seek immediate medical attention if they experience any of these symptoms after taking Depakote ER.

Frequently Asked Questions (FAQ)

How is Depakote ER administered?

Depakote ER is taken orally as a whole tablet with food, one to two times a day, depending on the patient's medical condition and healthcare provider's recommendation.

Can Depakote ER be used during pregnancy?

Depakote ER may cause harm to a developing fetus and should not be used during pregnancy unless the benefits outweigh the risks. Patients should inform their healthcare provider if they are pregnant or planning to become pregnant.

Is Depakote ER addictive?

Depakote ER is not considered addictive. It is not a controlled substance and does not produce the same kind of euphoric effects as drugs of abuse.

Can Depakote ER cause weight gain?

Yes, weight gain is a common side effect of Depakote ER, but not every patient will experience it. Patients should talk to their healthcare provider if they have concerns about weight gain.

Resources

• https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021168s016lbl.pdf
• https://www.drugs.com/mtm/depakote-er.html
• https://www.webmd.com/drugs/2/drug-19881/depakote-er-oral/details
• https://www.epilepsy.com/tools-resources/seizure-medication-list/divalproex-sodium-er
• https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0dc024ce-efc8-4690-7cb5-639c728fccac