Every disease requires the development of a special treatment method. Bipolar depression is more complicated in this aspect due to the combination of two types of opposite symptoms: depressive episodes are characterized with extremely low spirits, melancholy, no desire to do anything and even to live; manic episodes of the disease are manifested through the hyperactivity, inexplicable enthusiasm, and blind optimism.
However, manic episodes carry potential danger to the ill person and to people surrounding a sufferer. Mania makes a person over self-assured in his or her physical and mental abilities; it takes away the sense of fear and caution, throwing a sufferer into the feeling of almightiness. As a result, a person cannot control him-/herself and the things he or she does.
On the other hand, manic episodes aggravate sufferer’s anger, aggressiveness, and violence, which can result in hurting somebody or committing a crime.
One of the most popular drugs, which are capable of suppressing mania symptoms, is Depakote. Its active ingredient is divalproex sodium made of equal quantities of valproic acid and sodium valproate. Scientists suggest that the drug works by increasing the levels of gamma-aminobutyric acid (GABA) and affecting cell membranes within the brain.
It is reported that the adverse reactions occurrence is the highest at the beginning of the treatment. The most common side effects include nausea, vomiting, diarrhea, abdominal pain, weakness, dizziness and sleepiness. More serious adverse events reported are: aggravation of depression, aggression, and psychosis. In rare cases liver and pancreas damage was observed, in the majority of cases it developed during the first six months of the treatment.
The usual initial dose of the drug is 750 mg a day divided into smaller doses. With the lapse of time the dose may be increased in accordance with the patient’s disease severity and overall health state. It is recommended for the patients to drink plenty of water or other fluids during the treatment period, otherwise dose adjustment may be necessary.
Stopping the treatment should be done gradually, like with many other mental diseases drugs.
The use of Depakote is not recommended in people with the history of bleeding or blood clotting disorders, liver and pancreas diseases, head injuries, HIV and CMV infections, and urea cycle disorder. A patient should also inform a doctor about a family history of these diseases. By the way, Depakote increases a risk of bleeding, since it delays blood clotting.
Common contraindications include pregnant and breastfeeding women (Depacote passes into the breast milk and can cause multiple birth defects or death of the baby), people allergic to the drug’s ingredients, and children under 18.
Food is said to slow down the absorption of Depakote. Alcohol, antidepressants, anticonvulsants, and tranquilizers increase sedative effect of the drug. Patient should also be cautious when using Depakote with antibiotics, anticoagulants, antitubercular rifampin, and some other drugs. Be sure to inform your healthcare provider about any pills you are currently taking.
It should also be noted that the use of these pills is usually limited to the short period. Depakote proved to give positive results on eliminating mania symptoms of bipolar depression as soon as in three weeks. However, treatment can be prolonged by a doctor in certain patients.
A few years ago Depakote was used mainly for reducing seizures occurrence in epileptic patients and migraine headaches relief. Occasionally, it was taken by patients to eliminate anxiety and panic attacks. It was also prescribed for limiting the recurrence of manic episodes of bipolar depression. These days, physicians tend to prescribe it for the management of both manic and depressive episodes of the latter disease.
Although it is underlined that no sufficient scientific data is available on the issue, doctors sometimes prescribe Depakote for long-term treatment of bipolar depression. It is expected that the necessary studies will be carried out soon to evaluate the risks and benefits of long-term Depakote therapy.
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