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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by MJC on October 17, 2002, at 12:12:14
Hey, I just started taking this drug last night and I already feel really sedated today. I always give my medication at least a 4-week trial before switching it, so I've got a few questions about this.#1) Does this sedation feeling go away with time? Today I feel really groggy and out of it.
#2) What are some tips to keep my weight relatively low and decrease my appetite on this medication? Already this morning I had 4 bowls of cereal before I started feeling full. Damn... if I keep eating like that, I'm going to be into some financial trouble.
Any feedback would be appreciated,
thanks
Posted by melinda on October 17, 2002, at 17:57:10
In reply to Questions about Depakote (Epival), posted by MJC on October 17, 2002, at 12:12:14
Hi MCJ
When I took Depakote, the sedation lessened over time, but it never went away completely. As for the hunger, that didn't go away. I had to learn to live with it. At first I just ate when ever I was hungry. After some weight gain, I learned to eat only at meal times, despite being hungry in between meals. It might differ for each person though.
-melinda
Posted by judy1 on October 17, 2002, at 18:12:30
In reply to Questions about Depakote (Epival), posted by MJC on October 17, 2002, at 12:12:14
I agree with Melinda's comments- but just to add my own- after about 1-2 weeks your dr. should request a blood level test. If it is too high, you may be able to decrease your dose and find the sedation less of a problem. May I ask what dose you are taking? When manic, I have to have blood levels in the 100 range (sorry, I forgot the units) which requires 1500mg/day- but that is for a psychotic manic episode. If you only have hypomanic episodes (bipolar 2), then 60-70 is an effective level and depending on your size and/or metabolism is usually achieved at 750mg/day. You should always be monitored to check your liver in addition to your blood levels. Best of luck, judy
Posted by MJC on October 17, 2002, at 18:28:45
In reply to Re: Questions about Depakote (Epival) » MJC, posted by judy1 on October 17, 2002, at 18:12:30
Hey, this is my first day on the medication. My starting dose is 125mg at nighttime. It's for treatment of Bi-Polar II. I just found that I felt really groggy and sleepy most of the day. I've also been having mad mood swings, like one minute I feel like I'm going to cry, about 15 minutes later I'm ready to knock somebody out. I'm really just kind of a bit worried since I'm probably going to wind up being on this drug, or a drug similar to this, for a good portion of my life and I don't know what to really expect out of it.I know just about any drug causes sedation the first week or so that it's in your system, but what is my mind going to be like after that? Being able to think clearly is a very important thing for me.
Are these mood swings that I'm going through today a normal start up side effect of the medication? I thought it was to make me less irritable and to "stabilize" my mood, not make me into a bouncing ball of emotions.
Lastly, what about this weight gain? How much can I expect to gain on this medication? I've seen some posts on here where people claim to have gained about 100lbs. That would take me to about 300lbs and I sure as Hell don't want to be in that range. Is there anything that I can do, or that you suggest that I start doing, in order to fight off this weight gain or at least minimize it?
I'm 24 years old, I weigh about 200lbs and I'm about 5'8.
I'm also currently taking Effexor XR at 36-hour intervals and Clonazepam at about 1.5mg per day (usually less).
Posted by judy1 on October 18, 2002, at 19:32:51
In reply to Re: Questions about Depakote (Epival) » judy1, posted by MJC on October 17, 2002, at 18:28:45
Hi,
My first reaction to your mood swings is effexor- how long have you been on it? have you had a recent dose increase? ADs are contraindicated by every bipolar specialist I have seen (sorry to keep repeating this). You are on a very minimal dose of depakote, so you must be pretty sensitive to meds; as you suspect the sedation will wear off. I was on just about every mood stabilizer made, and depakote is the only effective one for my manic episodes- I do not take it daily, however- I take it when I am starting an episode. This is a fairly controversial approach, and will only work if you have a very trusting relationship with your shrink. When I took it on a daily basis (for a couple of years) I gained a few pounds- zyprexa is the real villian when it comes to weight gain. If you feel the effexor is not the cause of your mood swings, then you may be going through some cycling right now and the amount of depakote you are taking is not enough to stop that. I suggest you tell your pdoc, I imagine he was trying to take you up slowly to an effective dose because of your sensitivity to medication. hope this helped some- judy
Posted by Ritch on October 18, 2002, at 21:51:12
In reply to Re: Questions about Depakote (Epival) » MJC, posted by judy1 on October 18, 2002, at 19:32:51
> Hi,
> My first reaction to your mood swings is effexor- how long have you been on it? have you had a recent dose increase? ADs are contraindicated by every bipolar specialist I have seen (sorry to keep repeating this). You are on a very minimal dose of depakote, so you must be pretty sensitive to meds; as you suspect the sedation will wear off. I was on just about every mood stabilizer made, and depakote is the only effective one for my manic episodes- I do not take it daily, however- I take it when I am starting an episode. This is a fairly controversial approach, and will only work if you have a very trusting relationship with your shrink. When I took it on a daily basis (for a couple of years) I gained a few pounds- zyprexa is the real villian when it comes to weight gain. If you feel the effexor is not the cause of your mood swings, then you may be going through some cycling right now and the amount of depakote you are taking is not enough to stop that. I suggest you tell your pdoc, I imagine he was trying to take you up slowly to an effective dose because of your sensitivity to medication. hope this helped some- judyHi Judy, I am fascinated by your approach to your Depakote. I'm a 3-wk. rapid cycler, so I can't stop it *completely* and then restart. Depakote also is the only thing I have taken that knocks out hypomania/rage (reliably)and I have found recently that I can bump my Depakote 250mg dosage to 500mg just for the three-four days of the hypomanic part of my cycle and it seems to be working well enough that my mood chart is starting to become a little blurred and unremarkable. It *does* take a lot of insight to take the extra dose of an antimanic when you are feeling so *good*.
Posted by judy1 on October 19, 2002, at 23:05:41
In reply to Re: Questions about Depakote (Epival) » judy1, posted by Ritch on October 18, 2002, at 21:51:12
Hi Ritch,
I'm glad this approach works well for you, since you are charting your moods obviously you've taken responsibility. It IS difficult to take medication at the start of an episode, but as you've probably discovered you save yourself a lot of grief by doing so. I had an extra incentive, because I'm BP 1, I was landing up in hospitals when I ignored the warning signs. It does take pressure from my pdoc and therapist though- I still can't do it by myself- so I'm really impressed that you are able to. Another perk of not going up is not going down- as you've discovered with the evening of your moods. Congrats!- judy
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