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jmc
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Depakote
« on: Mar 6th, 2007, 2:57pm »
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Hello all, I just got back from my first neuro visit for clusters and he prescribed depakote (as well as verapamil, and *thank God* Oxygen!!!)
 
My question is about Depakote.  Anybody here have any insight on this? I did a search with limited results.
 
It is supposed to be for treating seizures i think.
 
Does it sound like I'm going in the right direction with those 3 weapons as well as the Imitrex Nasal Spray I've been using (with limited success)?
 
Thanks guys!!!
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burnt-toast
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Re: Depakote
« Reply #1 on: Mar 6th, 2007, 4:00pm »
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http://www.drugs.com/alpha/d4.html
 
Hear is a link that will help.  It contains multiple references to Depakote.  Be sure to read all the references to to this drug and any other drugs being considered.  
 
My Neuro wants to prescribe it but won't as long as I can't taper off of Lithium & Verapamil.  Both affect liver function and Verapamil can cause dizziness - all side effects that can be intensified by Depakote.    
 
I know a lot of folks take it.  You'll need to make your own choices but Depakote is the one drug that I've been afraid to take.  
 
Depakote can cause sudden and severe damage the liver and Pancreas.  Side effects that worsen very rapidly and can result in death.  
 
Read carefully and best wishes.
 
Tom  
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Re: Depakote
« Reply #2 on: Mar 6th, 2007, 4:30pm »
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Well that just scares the hell outta me.  Do people here take Depakote with Verapamil?  Because that is seemingly what my neuro wants me to do.
 
Thanks toast!
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Re: Depakote
« Reply #3 on: Mar 6th, 2007, 4:38pm »
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What the hell.  It's worth a try.  Some people say this helps them.  I tried Depakote and got nothing from it.  No effects, no side effects and no relief.
 
The side effect profiles for some drugs are downright scary.  Something you have to remember, though, is that not everyone suffers all or even most of the side effects listed.  Most people are able to take these drugs with minimal problems.  Yes, you should be aware of the potential side effects, but don't let them keep you from trying the drug.  There are usually specific sets of circumstances listed where you should not try the drug.  If your situation doesn't fall in those cases, give it a shot.  
 
 
Something I have noticed is that some people are as (or more) afraid of the stigma a drug carries as they are of it's side effects.  For example, they are afraid to take Lithium, because it is for "crazy people."  Oh my God! What will the neighbors think?  Screw that.  The most important thing is will it help.  It's none of their business what you take anyways, unless they have ch.  Then you may want to share what works for you and what hasn't.
 
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Re: Depakote
« Reply #4 on: Mar 10th, 2007, 8:15am »
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been taking depakote and verapimil together for a couple of weeks now and if it is working at all, i cant imagine how horrible i would feel without it. Undecided
 
thats the problem i always have with new meds.  I think that maybe it is working  a little, and without it instead of haveing four headaches a day, I would be haveing ten.
 
all in all though, i cant tell any side effects from it though.  maybe you should give it a try.  I dont think its working for me but htere must be some people who it has helped or they wouldnt keep prescribing it.
 
chrisw
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Lizzie2
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Re: Depakote
« Reply #5 on: Mar 10th, 2007, 8:45pm »
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I took depakote, but not at the same time as verap.  The two combined shouldn't be a problem as far as the liver is concerned - at least from what I remember.  BUT - I'm assuming here no primary liver issues, and this is off the top of my head.  (In other words, no holding me responsible!!)  When you read online info about depakote (and a lot of drugs, frankly), it makes it look really scary.  One of the most important things is that liver function tests must be done regularly while on the depakote.
 
It is primarily an anticonvulsant (anti-seizure drug), but has been used for both cluster and migraine for a lot of years.  It was actually like the 3rd drug I ever tried for chronic migraine (this was before I had clusters), and it actually did help...problem was that I got a lot of acid reflux (heartburn) from it - although I have had reflux since birth, so I'm not sure if it affects everybody that way.  It made me veryyyyyyy tired - I used to sleep through 4 alarm clocks and my mom would call me in college to wake me up to go to my 8am class - and even then, I think I still missed a lot of classes!  I'd fall asleep in classes while trying to take notes - half my notes from when I was on it are chicken scratch.  I used to think it was just because I get bored and sleepy when sitting in lectures, but it was actually the med.  It also made me very puffy and some of my hair fell out - my lips got some sores and were very peely... (it's acidic)  I looked sick....  Thing was, I was getting puffy and looked like I was gaining weight, even though I couldn't even eat from the acid reflux.  I went on my first reflux med while on depakote - I took prilosec.
 
NOW - that being said, not everybody has those side effects.  I know people who have taken depakote with no problems whatsoever.  It does tend to have a lot of side effects, but the important thing is to start low and increase slowly.  When you read the side effect/adverse effect list on the web, it always sounds bad.  But keep in mind that a lot of the side effects listed (or adverse reactions) happen to like <1% of people, but if it happened to somebody, they have to list it.  
 
If you have a problem with acid reflux and even just self-treat with over the counter zantac, tums, anything - I'd maybe ask your doc if you can try something stronger if you have a problem with the reflux on depakote.
 
My personal feeling is that it's worth trying - and if you experience side effects, you can always come right off.  As long as they are monitoring liver function, then if they start to see levels rise, they can take you right back off and the liver should normalize.  There have been cases where one dose really nails somebody's liver, but I think this is more common with the IV form of valproic acid - Depacon.  This one is a lot more bang for the buck.  Even I had elevated liver function while on the IV form in the hospital for 3 days.  They can only use that for a few doses IV before it effects the liver.  If you don't have a pre-standing liver disease or condition, that's at least a good start.  Do you have high triglycerides?  Something else to just ask about.  Any family history of liver problems?  Do you drink a lot?  If you drink, you should really let your MD know how often, what type ,etc.  People often don't want to tell the doc that they drink, even if it's just 1 beer a night, but docs aren't there to be judgemental - withholding info like that could cause much worse problems.
 
Traditionally, there are 5 preventive meds that are known to work for CH'ers - those meds are: Depakote, Lithium, Verapamil, Melatonin, and topamax.  Steroid tapers often work as a transition while preventives are building in the blood stream.  Lots of people here have had success with verap/lithium combos.  I don't know as many people on verap/depakote combos, but it's worth trying!  While not commonly done (and part of the reason is because of insurance), frovatriptan is sometimes used as a daily prevent - probably not long term, though.  Most docs don't prescribe the ergotamines as preventives anymore - sansert is no longer available in the United States - and the only one left is methergine (methylergonavine), but it has a lot of side effects.  There are also the older ones like cafergot and so on, but I don't know many docs who write for those at all.
 
I think your doc sounds like he's started you off on a good plan.  Just keep track of any side effects and make sure you tell him about everything!  The verap can cause some dizziness, lightheadedness, and low blood pressure among some other things.  If you note any chest pain/palpitations, it's important to call the doc right away.  Oh and one last thing - not sure if your doc prescribed the regular release version of depakote or the extended release (Depakote ER), but if you get a lot of side effects, you could always ask to try the extended release version.  Supposedly it has less side effects.  I did try it, but still had too many side effects unfortunatley....
 
Best of luck and let us know how it turns out!
 
Carrie Smiley
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Re: Depakote
« Reply #6 on: Mar 10th, 2007, 8:51pm »
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Oh I had another thought about this....
 
Is he having you start verapamil and depakote brand new at the same time?  Personally, I prefer to start new meds one at a time.  For one thing, you may get more side effects if you are trying two new meds at once - and then it's hard to tell which med is causing the side effects - especially if they can have some similar side effects.  (Both depakote and verap can cause fatigue - although the way they cause it is different...as an example.)  Likewise, if you find they are helping, it's hard to know which one is actually helping or if it is an additive effect.  And if you start with one, and that helps, then maybe you wouldn't need to add the 2nd one.  Plus, if you truly figure out which one kinda helps or if one has bad side effects but the other doesn't...then you could go off the one that was causing problems or not working and then add something else to the one that is working.  Say the verap doesn't help but doesn't hurt  but the depakote has side effects.  Well, then maybe you could come off the depakote and try lithium with the verap.  It's all about the combinations sometimes.  Verap might not work up front, but combined with lithium for some people, it's the right combo.  Who knows - just some thoughts.  I personally wouldn't want to start 2 at the same time, but I'm not a doc - and he may have his reasons if that is the case!  If I were you, I'd get a notebook or something and try to right down meds, when you take them, what times you get attacks, how long, how bad are they, what side effects do you have, what other things do you try if you get an attack, etc.  That way you can track how well it works.
 
Sometimes things appear not to work well, but it's because our mind sort of resets itself.  So many times I've thought something isn't helping - but it's because my 1-10 baseline resets itself, and then I realize it was helping but only after I've come off it and returned to how bad I was before.
 
Sorry so much - just had a lot of thoughts on it!
 
PF wishes, and I truly hope it works!!
Carrie Smiley
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SophiaK
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Re: Depakote
« Reply #7 on: Mar 11th, 2007, 12:59pm »
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Depakote is a sulfa drug, if you have problems with sulfa, don't take it.
depakote cause my liver to malfunction terribly, caused problems I will not describe here. I now have a scared liver.
Did your doctor tell you to have blood tests for your liver while taking depakote? If not, ask for it and get it done.
Depakote did have some desired effect, however I was taking predisone at the same time.  All drugs were removed and I was put on Verapamil for A Fib.  Verapamil did not calm down the beast.  I went for Shrooms, cause Ijust couldn't live like this any longer, they have helped me and I am seemingly getting better all the time. (she says with her fingers crossed. Good luck.
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Re: Depakote
« Reply #8 on: Mar 11th, 2007, 2:23pm »
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I believe I took up to 1750mg/day and it didn't help anything. The attacks were frequent and relentless!
 
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Re: Depakote
« Reply #9 on: Mar 11th, 2007, 3:43pm »
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Sophia, where did you get this information?  I'm looking, but I can't find anything that says Depakote is a sulfa drug.  I even called my pharmacist and he said Depakote is not sulfa based.
 
Are you sure you aren't confusing Depakote with Zonegran?
 
 
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Re: Depakote
« Reply #10 on: Mar 12th, 2007, 7:22am »
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I've searched high and low and cant find any referance to Depakote being a sulfa drug.
 
Sulfa drugs are antibiotics.
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jmc
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Re: Depakote
« Reply #11 on: Mar 14th, 2007, 11:21am »
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Thanks for all the help guys!!!  My doctor said nothing of testing my liver function though, but that makes sense... I'll inquire.  Since taking prednisone I only had CHs for another week (and less severe ones at that).  Now it's been over a week without a CH at all, and that's without any meds.  I think maybe the prednisone shortened my cycle as I feel good... I hope it lasts.
 
As a result I have not started the Depakote or Verapamil and won't until they come back (doctor's orders).  Is this a mistake?
 
I am scheduled to go back and get an MRI soon to rule out an aneurism.  
 
Anyhow, thanks for all the support.  PFDANs to all of you good people!!!
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Re: Depakote
« Reply #12 on: Mar 14th, 2007, 3:22pm »
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Its never a mistake to follow the docs orders Grin
At least not your mistake.
the pred is a transitional abortive. It does sometimes break an episode, and sometimes not. If it did ...enjoy.
jb
Regarding the depakote or any other drug for that matter, do not quit these cold turkey without consulting your doc.
your in the right direction..all the best
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