Anyone on Lithium *and* Depakote??
Question:
My psychiatrist has me on a full therapeutic dose of Lithium (average blood level 1.0-1.2) *and* is having me work up to a full therapeutic dose of Depakote. Does anyone know the rationale for this (as opposed to eliminating the Lithium & switching to Depakote)? Also, I find myself extremely sedated by the Depakote, and I *swear* it’s causing weight gain (though my psychiatrist says "no, no, Depakote doesn’t cause weight gain; it must be the Lithium.") I’m totally confused and find it hard to convince myself to take these medications. Anyone have experience with this? Jenny
Response:
> > My psychiatrist has me on a full therapeutic dose of Lithium (average > blood level 1.0-1.2) *and* is having me work up to a full therapeutic > dose of Depakote. Does anyone know the rationale for this (as > opposed to eliminating the Lithium & switching to Depakote)? > Also, I find myself extremely sedated by the Depakote, and I *swear* > it’s causing weight gain (though my psychiatrist says "no, no, [...]
Your doc is wrong. Depakote has been widely reported to cause weight gain. I would not be surprised to find Lithium associated with weight gain as well. Of course any medicine that slows manic attacks probably leaves patients open to some weight gain. If my doc had me on Lithium and Depakote at the same time I would worry about possible onset of depression, along with side effect hell, and toxicity. Why aren’t you and your doc talking about your meds? Your doc’s rational for presciptions should be absolutely clear to you…you need to know what/when and why or else you are being left out of YOUR health care. It is clear that your doc doesn’t take your concerns very seriously in that your response to a medication side effect is being shrugged off. Your doc/my doc etc…are not taking these meds with us 2-3 times a day and they don’t have to deal with the side effects. If you are on a med and you don’t like it…make your doc listen–or find a doc who will. All meds have side effects and dangers. Patients who know about their meds are more likely to remain on them safely. For many of us meds are necessary for life…they are too important to be taken without knowledge and consent. Phoenix.
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> My psychiatrist has me on a full therapeutic dose of Lithium (average > blood level 1.0-1.2) *and* is having me work up to a full therapeutic > dose of Depakote. Does anyone know the rationale for this (as > opposed to eliminating the Lithium & switching to Depakote)? > Also, I find myself extremely sedated by the Depakote, and I *swear* > it’s causing weight gain (though my psychiatrist says "no, no, > Depakote doesn’t cause weight gain; it must be the Lithium.") I’m > totally confused and find it hard to convince myself to take these > medications. Anyone have experience with this? > Jenny
My wife is on both medications. She’s bipolar, with severe manic episodes. She found that Litium alone and Valparoic acid alone didn’t stop her from having manic episodes and being hospitalized. But for the past year she’s been on both medications and so far (fingers crossed) the combination seems to be working. She has had some considerable weight gain, apparently because of the lithium, also some tremours in her hands, as well as some hair thinning. But as she says, "these are nothing so long as I don’t have to go back onto the psych ward." Chris
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Don’t know much about Lithium, but under Depakote I’ve gained 20 pounds, and my doctor has not once denied that the Depakote is to blame. Omri Schwarz
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I was on Lithium for about 6 years then Depakote for 6 weeks. I now am on both. Depakote relieved me of a lot of side effects Lithium gave me. But it was only doing a good job of controlling racing and obsessive thoughts and not enough for emotional control and hypersensitivity. So I was acting like I had PMS all the time. (I bet PMS and this emotional problem have similar chemical causes in the brain.) It only takes me 225 mg/day of Eskalith to cover my emotions and hypersensitivity. To get it to control thoughts, I have to have four times that amount. And then I get significant side effects. So I take 1500 mg/day Depakote to do most of the manic control and 225 mg/day Eskalith to do the emotional control. My psychiatrist said I was a very good doctor to come up with this plan. I think that enough experiments and the desire to tweak it in has made me a pretty good doctor for myself, but that’s all. It pays to listen to what’s going on and think about what these drugs are really doing. "Listening to Mood Controllers"? We’ll see how this formula holds up as things drift around. Kurt
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Most definetely you gain weight when your on Lithium. If you’ve been manic or depressed for years when you start taking Lithium and probaly Depakote you slow down eat more and run around less. I have five members in my family with Bi-polar disorfer and we all have gained weight on Lithium. I’ve gained 25 pounds. For me it’s time to get back to gym What ever you do take your medicine. I’de rather be fat then dead. I may be fat but I sure feel good about myself. Bye-bye- I think I’ll go have a twenky:) Ben
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Owl… ugh…I have just read the post I wrote in response to your question about Lithium and Depakote. Sorry I came off sounding so bossy. I do think docs who fail to fully inform their patients about treatment are neglecting their duties as healers, but I do not want to blame you for the situation. We can often to a lot to increase our strength but rarely can we do that when we are already confused and then attacked to boot. Please forgive me for giving you such a hard time. I do wish you lots of luck in finding a good working relationship with your doc. Phoenix.
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Lithium independly may not do the trick for everyone. The combo of Valproic acid and Lithium does seem to work better for some people. Weight gain however is tied to Valproic, at least in my case. Slight weight gain.
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>My psychiatrist has me on a full therapeutic dose of Lithium (average >blood level 1.0-1.2) *and* is having me work up to a full therapeutic >dose of Depakote. Does anyone know the rationale for this (as >opposed to eliminating the Lithium & switching to Depakote)? >Also, I find myself extremely sedated by the Depakote, and I *swear* >it’s causing weight gain (though my psychiatrist says "no, no, >Depakote doesn’t cause weight gain; it must be the Lithium.") I’m >totally confused and find it hard to convince myself to take these >medications. Anyone have experience with this? >Jenny
Jenny I have taken lithium and depakote simultaneously. For the last 4-5 years I have taken only Depakote (along with a host of other antidepressants, etc.) Most people taking lithium for a period of years will find it has affected their thyroid gland resulting in hypo-throidism. The a couple of symptoms of this is weight gain and unrelenting fatigue. Ask your doctor to run a throid scan not just the common 4, but all 5. Mine was found in the 5th. Anyway, I agree with Phoenix. You need to discuss this with your doctor. If he is reluctant to or won’t answer your questions, I’d consider finding a new doc. Chances are good, however, if you go to him with a WRITTEN LIST of questions, he will spend more time with you. Most docs are impressed when their patients take an active roll in their treatment plans and you may very well find that you are receiving better care. That has been my experience from the beginning. Educate yourself. Ask about reading materials. Most are available from local libraries. Get into support groups. Take care and don’t give up the battle. The Wild Woman
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your doctor is absolutely wrong if he or she is tellin you that depakote does not cause weight gain. It does. In fact it can cause hyperinsulin prodution which can cause SEVERE weight gain. I probably sound like a broken record, but make sure your doctor knows this or find one who does. I take depakote and have gained nearly 20lbs. I am holding steady there and trying to lose a little of it. Have your doctor get the May 1996 copy of Annals of Neurology Vol39 No.5 and read the article entitled Obesity and Endocrine Disorders In Women Taking Valproate for Epilepsy. (in women, only because they haven’t studied men) Once I presented this article to my pdoc and gynocologist, I was taken seriously and feel confident that I am on the right things and testing for the right problems. I’ll post it if there is an interest. take care ms manic
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– Hide quoted text — Show quoted text ->your doctor is absolutely wrong if he or she is tellin you that depakote >does not cause weight gain. It does. In fact it can cause hyperinsulin >prodution which can cause SEVERE weight gain. I probably sound like a >broken record, but make sure your doctor knows this or find one who does. >I take depakote and have gained nearly 20lbs. I am holding steady there >and trying to lose a little of it. >Have your doctor get the May 1996 copy of Annals of Neurology Vol39 No.5 >and read the article entitled Obesity and Endocrine Disorders In Women >Taking Valproate for Epilepsy. (in women, only because they haven’t >studied men) Once I presented this article to my pdoc and gynocologist, I >was taken seriously and feel confident that I am on the right things and >testing for the right problems. I’ll post it if there is an interest. >take care >ms manic
I have been taking depakote for a year now and have gained almost eigthy pounds. I thought maybe I wasn’t excercizing enough, but I think I will look into the possiblity of the depakote as a factor.
Response:
- Hide quoted text — Show quoted text – > your doctor is absolutely wrong if he or she is tellin you that depakote > does not cause weight gain. It does. In fact it can cause hyperinsulin > prodution which can cause SEVERE weight gain. I probably sound like a > broken record, but make sure your doctor knows this or find one who does. > I take depakote and have gained nearly 20lbs. I am holding steady there > and trying to lose a little of it. > Have your doctor get the May 1996 copy of Annals of Neurology Vol39 No.5 > and read the article entitled Obesity and Endocrine Disorders In Women > Taking Valproate for Epilepsy. (in women, only because they haven’t > studied men) Once I presented this article to my pdoc and gynocologist, I > was taken seriously and feel confident that I am on the right things and > testing for the right problems. I’ll post it if there is an interest. > take care > ms manic
I have to disagree with the hyperinsulin part of this post. I’m diabetic type II, which means I produce *some* of my own insulin, but not enough and I have to inject the balance. Since I’ve been on depakote, I’ve had to INCREASE my injections. That would suggest HYPO-Insulin production.
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