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Re: Any bi polars on a maintenance dose of Depakote?

Posted by Chloe on February 7, 2002, at 19:23:03

In reply to Re: Any bi polars on a maintenance dose of Depakote?, posted by ST on February 6, 2002, at 21:18:47

> KK,
>
> Good to know others are on low doses as well. There are people who are at only 250 mgs? Go figure. I thought this was such a "risky" thing for me to be telling my doctor I wanted to do.
>
> > I am choosing to keep my Dep. level at 500 mg - my pdoc wants it at 1000. >
>
> So why does he want you at 1000? Why does he feel you can't make a choice about this? Are you going to work/school? Do you have good relationships with those close to you? If you're high functioning, you should be able to make these medication decisions. There are a lot of bi polars, I guess, who just like the "up" feeling and choose to lower their doses even though it isn't for their highest good. But there are some who have good reasoning abilities and do want to do what's best for their mental health, yet want to have a life as well.
>
>
> > My pdoc feels that Depakote is only for acute mania, >
>
> Supposedly it is. Lithium is what they usually use for maintenance. Depakote is not FDA approved to be used as such. However, my pdoc told me he was just at a bi polar lecture/seminar thingy and other doctors were talking about how Depakote IS used quite successfully for maintenace. He has other patients who are doing it. His peers are prescribing it for maintenance.
>
> > So why can't it also work at a therapeutic dose? I don't know how else to tell him that I feel better at 500 mg Dep., and, currently, 60 mg Prozac. >
>
> If you were to test your levels, perhaps it wouldn't be a "therapeutic" dose for you. I was tested over the summer while on 750 mg of Depakote and came up at a waaaaaay sub-therapeutic level. But, again, my doctor says just because the numbers say one thing, doesn't mean the result is subsequently going to be a textbook example. He told me many bi polars are at "sub-therapeutic" levels and do just fine. I would ask him why he feels you are not able to make such a choice.
>
> I was a baaaaad girl. I went down from 750 to 500 about three weeks ago on my own. At first I forgot to take my morning dose. Then another. Then another. When I realized this, I said to myself: "Let's see what happens if I stop that morning dose altogether..." So I did. And I feel like I'm living again. I then went in to my pdoc's office with a list of my traits and moods over the past three weeks at 500 mg. He couldn't argue. Obviously I was not hypomanic and I was functioning at a clearer, more alert level.
> I say stay at 500 mg for a couple of weeks and see how you feel. Then maybe go in to your doctors office armed with a journal of your moods after being on 500 mg.
>
> Let me know what happens!
>
> Sarah

Hi
I don't think one can go by the # of milligrams to determine a maintenance dose. Everyone metabolizes medications differently. 250 mgs for one person might be equivalent to 1000 mgs to another person's system. And it's also important to take into account a person's size, sensitivity to drugs and how much AD a person is taking along with the depakote.

So I would be careful not to get too hung up on the number of milligrams. But focus on the right amount of medication to be emotionally stabile and in control, without the loss of (too much!) quality of life.

Best,
Chloe


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poster:Chloe thread:93045
URL: http://www.dr-bob.org/babble/20020131/msgs/93236.html