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Does depakote cause depression


Depakote and Depakote ER Side Effects: Mild, Severe, and More

If you have epilepsy, migraine, or bipolar disorder, your doctor might suggest Depakote or Depakote ER* (divalproex) as a treatment option for you. These prescription tablets are used to:

  • treat focal seizures and absence seizures caused by epilepsy in adults and children ages 10 years or older
  • treat mania (episodes of intense high moods, hyperactivity, and similar symptoms) in adults with bipolar disorder
  • help prevent migraine headaches in adults

Depakote also comes as a sprinkle capsule. This form of the drug is prescribed to treat focal seizures and absence seizures in adults and children ages 10 years or older with epilepsy.

For more information about Depakote and Depakote ER, including details about the drugs’ uses, see this in-depth article.

Like other drugs, Depakote and Depakote ER can cause mild or serious side effects (also known as adverse effects). Keep reading to learn more.

* ER stands for extended release. This means the drug is released into your body gradually over time, starting right after you take a dose. The other forms of Depakote (the tablet and the sprinkle capsule) are delayed release. This means the drug is released into your body a certain amount of time after you take a dose.

Some people may experience mild or serious side effects during Depakote or Depakote ER treatment.

More common side effects in people taking Depakote or Depakote ER include:

  • headache
  • sleepiness
  • weakness
  • digestive side effects, such as nausea, vomiting, and diarrhea*
  • tremors (uncontrolled shaking)*

These are just a few of the more common side effects reported by people who took Depakote tablets, ER tablets, or sprinkle capsules in studies. These side effects can vary depending on what condition the drugs are being taken to treat.

* To learn more about this side effect, see the “Side effects explained” section below.

Like most medications, treatment with Depakote and Depakote ER may cause mild side effects. Examples of mild side effects that have been reported with Depakote and Depakote ER include:

  • belly pain
  • dizziness
  • headache
  • increased or decreased appetite
  • insomnia (problems sleeping)
  • mild, reversible memory loss
  • problems with coordination or walking
  • sleepiness
  • weakness
  • vision problems, such as blurred vision or double vision
  • digestive side effects, such as nausea and constipation*
  • hair loss*
  • tremors (uncontrolled shaking)*
  • weight gain or weight loss†

* To learn more about this side effect, see the “Side effects explained” section below.
† To learn more about weight changes with these drugs, see the “Can Depakote and Depakote ER cause weight gain?” section below.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And don’t stop taking Depakote or Depakote ER unless your doctor recommends it.

Depakote and Depakote ER may cause mild side effects other than the ones listed above. For details, see the prescribing information for the Depakote tablets, Depakote sprinkle capsules, and Depakote ER tablets.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Depakote or Depakote ER, visit MedWatch.

Serious side effects that have been reported with Depakote and Depakote ER include:

  • bleeding problems and low blood platelet levels
  • high blood ammonia levels
  • hypothermia (low body temperature)
  • suicidal thoughts and behaviors
  • liver damage*†
  • pancreatitis (swelling and damage of the pancreas)*†
  • fetal harm, if taken during pregnancy*‡
  • allergic reaction†

If you develop serious side effects while taking Depakote or Depakote ER, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* Depakote tablets, Depakote ER tablets, and Depakote sprinkle capsules have a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA).
† To learn more, see the “Side effects explained” section below.
‡ To learn more, see “Pregnancy and breastfeeding while taking Depakote or Depakote ER” in the “Warnings for Depakote and Depakote ER” section below.

SUICIDE PREVENTION

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Get answers to some frequently asked questions about Depakote and Depakote ER’s side effects.

Do older people have a higher risk of Depakote and Depakote ER side effects compared with younger adults?

Yes, older people may have a higher risk of certain side effects of Depakote and Depakote ER. In studies of Depakote tablets, ER tablets, and sprinkle capsules, people ages 65 years or older were more likely to report:

  • accidental injury
  • infection
  • pain
  • sleepiness
  • tremors (uncontrolled shaking)*

To learn more about your risk of side effects with Depakote or Depakote ER, talk with your doctor or pharmacist. They can tell you more about whether your health history, including your age, puts you at higher risk of side effects.

* To learn more about this side effect, see the “Side effects explained” section below.

Can Depakote and Depakote ER cause long-term side effects?

Yes, it’s possible for Depakote and Depakote ER to cause long-term side effects.

Liver damage, including liver failure, has been reported. Pancreatitis (swelling and damage of the pancreas) has also been reported, including in people who’ve taken Depakote for years. Liver damage and pancreatitis are long-term side effects.

Depakote and Depakote ER have a boxed warning for risk of liver damage and pancreatitis. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). See “Side effects explained” below to learn more.

You can also talk with your doctor or pharmacist to learn more about long-term side effects with Depakote and Depakote ER.

If I take too much Depakote or Depakote ER, will I have overdose symptoms?

Yes, taking too much Depakote or Depakote ER can cause overdose symptoms, such as:

  • deep (severe) coma
  • heart block (irregular heart rhythm due to a problem with the heart’s electrical signals)
  • low blood sodium levels
  • sleepiness

In very rare cases, death has occurred due to overdose with Depakote or Depakote ER.

Do not take more Depakote or Depakote ER than your doctor prescribes. If you think you’ve taken too much Depakote or Depakote ER, call your doctor right away. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. If you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

Can Depakote and Depakote ER cause sexual side effects in men and women?

It’s possible. Studies have found that valproic acid can affect sex hormones and cause certain sexual side effects. The active drug* in Depakote and Depakote ER, divalproex sodium, is a form of valproic acid.

Sexual side effects of valproic acid can include erectile dysfunction in males† and period irregularities in females.† Valproic acid can also decrease libido (sex drive).

If you’re concerned about sexual side effects with Depakote or Depakote ER, talk with your doctor. They may be able to recommend treatment for any sexual problems you’re having. They may also suggest stopping Depakote or Depakote ER and trying a different medication for your condition.

* The active drug is the ingredient that makes a medication work.
† Sex and gender exist on spectrums. Use of the terms “male” and “female” in this article refers to sex assigned at birth.

Does the risk of side effects increase with higher doses of Depakote or Depakote ER (125 mg, 250 mg, 500 mg)?

It’s possible. But in most of the studies of Depakote tablets, ER tablets, and sprinkle capsules, researchers didn’t compare how different doses might have impacted side effects. So it’s not known whether the risk of most side effects increases with higher doses.

It is known that if you take Depakote or Depakote ER while pregnant, the risk of fetal harm increases with higher doses. Depakote and Depakote ER have a boxed warning about risk of fetal harm. For details, see “Pregnancy and breastfeeding while taking Depakote or Depakote ER” in “Warnings for Depakote and Depakote ER” below.

You can also talk with your doctor or pharmacist for more information.

Taking Depakote and Depakote ER can cause weight gain. This side effect was reported in studies of Depakote tablets, ER tablets, and sprinkle capsules.

Weight loss, increased appetite, and decreased appetite were also reported. Appetite changes can affect your weight.

Keep in mind that appetite loss can be a sign of serious side effects from Depakote or Depakote ER. These include liver damage and pancreatitis (swelling and damage of the pancreas). Depakote and Depakote ER have boxed warnings for these side effects.*

If you’re concerned about weight gain while taking Depakote or Depakote ER, talk with your doctor. They can suggest ways to maintain a weight that’s healthy for you.

* Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). See “Side effects explained” below for more information.

No, withdrawal symptoms haven’t been reported with Depakote tablets, ER tablets, or sprinkle capsules. These are side effects that can happen when you stop taking a medication your body is dependent on. Depakote and Depakote ER aren’t known to cause dependence or withdrawal.

But stopping Depakote or Depakote ER could cause symptoms of your condition to return. For example, if you’re taking the drug to help prevent migraine headaches, stopping the medication could cause your migraine headaches to return.

Talk with your doctor if you’re interested in stopping Depakote or Depakote ER. They can advise you on how to do it safely. They can also discuss other treatment options for your condition.

Learn more about some of the side effects Depakote and Depakote ER may cause.

Hair loss

It’s possible to have hair loss as a side effect from taking Depakote or Depakote ER. This side effect was reported by people taking the medication to treat seizures or help prevent migraine headaches. It wasn’t common, though.

Hair loss wasn’t reported by people taking Depakote or Depakote ER to treat mania caused by bipolar disorder. (Mania refers to episodes of intense high moods, hyperactivity, and similar symptoms.)

Hair lost during treatment will usually grow back after you stop taking Depakote or Depakote ER.

What might help

Contact your doctor if you have hair loss that bothers you while taking Depakote or Depakote ER. They may recommend a treatment for this side effect. Or they may recommend trying a different treatment for your condition.

Tremors

Tremors are a possible side effect of Depakote and Depakote ER. Having tremors means you have shaking that you can’t control, which might affect one body part (such as one hand).

This side effect was most common in people taking the medication to treat seizures. Also, people ages 65 years or older may have a higher risk of tremors than younger adults.

What might help

If you have tremors that bother you while taking Depakote or Depakote ER, talk with your doctor. They can evaluate your symptoms for causes besides Depakote. If they determine that stopping Depakote is best for you, they can also recommend other treatments for your condition.

Digestive side effects, such as nausea and constipation

Digestive side effects are possible with Depakote and Depakote ER. These may include:

  • belly pain
  • constipation
  • diarrhea
  • nausea
  • upset stomach
  • vomiting

Nausea, vomiting, and diarrhea were some of the more common side effects of Depakote and Depakote ER.

What might help

Contact your doctor if you have digestive side effects while taking Depakote or Depakote ER. They can suggest treatment depending on the symptoms you have. If you have symptoms that bother you or don’t go away, your doctor may suggest a different treatment for your condition.

Liver damage

Liver damage is a rare side effect of Depakote or Depakote ER. These drugs have a boxed warning about risk of liver damage.

Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). They alert doctors and patients about drug effects that may be dangerous.

Liver damage from Depakote or Depakote ER can cause liver failure. This can be life threatening in extreme cases. But liver damage and liver failure weren’t common in studies of Depakote tablets, ER tablets, or sprinkle capsules.

Liver damage is more likely to happen during your first 6 months of taking Depakote or Depakote ER. But this side effect can happen at any time during treatment. And liver damage caused by Depakote can be long term.

Symptoms of liver damage can include:

  • appetite loss
  • extreme tiredness or fatigue (low energy)
  • generally feeling unwell
  • jaundice (yellowing of the skin or the whites of your eyes)
  • pain in your upper right belly
  • swelling in your face
  • weakness
  • vomiting

Due to the risk of liver damage, doctors usually will not prescribe Depakote or Depakote ER if you have liver problems. They also won’t prescribe Depakote or Depakote ER to people with certain mitochondrial disorders. *

While taking Depakote or Depakote ER, your doctor will closely monitor your liver health using blood tests. Your doctor can tell you more about how often you’ll have these tests while taking Depakote.

* See the “Warnings for Depakote and Depakote ER” section below for details.

What might help

If you notice symptoms of liver damage, contact your doctor right away. They’ll likely want to examine you. If they determine that you might have liver damage, they’ll likely have you stop taking Depakote.

Pancreatitis

Pancreatitis is a rare possible side effect of Depakote or Depakote ER. These drugs have a boxed warning about this side effect.

Pancreatitis refers to inflammation (swelling and damage) in your pancreas. Symptoms of this condition can include:

  • nausea or vomiting that doesn’t go away
  • severe belly pain, which might spread to your back
  • appetite loss

This side effect was very rare in studies of Depakote tablets, ER tablets, and sprinkle capsules. It can be life threatening or fatal in extreme cases.

What might help

Call your doctor right away if you notice symptoms of pancreatitis. Or call your local emergency number or go to the closest emergency room.

If your doctor confirms that you’re experiencing pancreatitis, they’ll have you stop taking Depakote or Depakote ER. They’ll also treat the pancreatitis. This may require treatment in the hospital.

Allergic reaction

Like most drugs, Depakote and Depakote ER can cause an allergic reaction in some people. This side effect wasn’t common in studies of Depakote tablets, ER tablets, or sprinkle capsules.

Symptoms can be mild or serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

Rarely, Depakote and Depakote ER can also cause a kind of allergic reaction called drug reaction with eosinophilia and systemic symptoms (DRESS). DRESS is most likely to occur within 2 to 6 weeks of starting treatment. DRESS can be life threatening or fatal in very rare cases.

DRESS often begins as a red rash on the face and upper body. Other symptoms can include:

  • burning pain in your skin
  • swelling in your face
  • fever
  • itchiness
  • swelling in your lymph nodes (such as in your armpits or your neck)
  • organ damage
What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter antihistamine you take by mouth, such as Benadryl (diphenhydramine). Or they may suggest a product you apply topically (to your skin), such as hydrocortisone cream.

If your doctor confirms you had a mild allergic reaction to Depakote or Depakote ER, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Depakote or Depakote ER, they may have you switch to a different treatment.

Keeping track of side effects

During your Depakote or Depakote ER treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose you were taking when you had the side effect
  • how soon after starting that dose you had the side effect
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were also taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help your doctor learn more about how Depakote or Depakote ER affects you. And your doctor can use this information to adjust your treatment plan if needed.

There are certain warnings to consider before taking Depakote or Depakote ER.

Boxed warnings

Depakote and Depakote ER have several boxed warnings. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). Depakote and Depakote ER’s boxed warnings are for risks of:

  • Liver damage. Depakote or Depakote ER can cause life threatening liver damage.
  • Pancreatitis (swelling and damage of the pancreas). Depakote or Depakote ER can cause pancreatitis, which can be life threatening.
  • Fetal harm. Taking Depakote or Depakote ER while pregnant can cause fetal harm.

For details about liver damage and pancreatitis, see the “Side effects explained” section above. And for more about fetal harm, see “Pregnancy and breastfeeding while taking Depakote or Depakote ER” below.

Other warnings

Depakote and Depakote ER may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Depakote or Depakote ER. The list below includes factors to consider.

Mitochondrial disorder. Having certain mitochondrial disorders can raise your risk of serious side effects, including liver damage, with Depakote or Depakote ER. Mitochondrial disorders are rare conditions caused by genetic changes that affect mitochondria (structures inside cells that produce energy). Due to the risk of liver damage, doctors usually won’t prescribe Depakote if you have certain mitochondrial disorders, such as Alpers-Huttenlocher syndrome. Your doctor can tell you about other treatment options that may be safer for you.

Mood problems, including depression or suicidal thoughts. Like all drugs prescribed to treat epilepsy, taking Depakote and Depakote ER can increase your risk of suicidal thoughts or behaviors. They can also cause or worsen depression. If you have mood problems or have had them before, be sure to tell your doctor. They can help decide whether Depakote or Depakote ER is safe for you to take.

Urea cycle disorder. If you have urea cycle disorder, your doctor usually won’t prescribe Depakote or Depakote ER. Rarely, life threatening or fatal blood levels of ammonia have been reported when people with this condition took Depakote tablets, ER tablets, or sprinkle capsules. Talk with your doctor about other treatments for your condition that may be safer for you to take.

Allergic reaction. If you’ve had an allergic reaction to Depakote or Depakote ER or any of their ingredients, your doctor will likely not prescribe any form of Depakote for you. Ask your doctor what other medications are better options.

Alcohol, Depakote, and Depakote ER

It may be best to avoid or minimize drinking alcohol while taking Depakote and Depakote ER.

Alcohol can worsen some side effects of Depakote and Depakote ER. These include dizziness, sleepiness, and liver damage. It’s important to note that Depakote and Depakote ER have a boxed warning for liver damage.*

If you drink alcohol, talk with your doctor about how much (if any) is safe for you to drink while you’re taking Depakote or Depakote ER.

* A boxed warning is the most serious warning from the FDA. See “Side effects explained” below for more information.

Pregnancy and breastfeeding while taking Depakote or Depakote ER

Below is information about taking Depakote and Depakote ER during pregnancy and breastfeeding.

Pregnancy

Depakote and Depakote ER have a boxed warning about fetal harm (commonly known as birth defects) if the drug is taken during pregnancy.

Studies of Depakote tablets, ER tablets, and sprinkle capsules have shown that taking these drugs while pregnant can result in serious problems in a fetus. These problems may include brain and spinal cord problems, and physical abnormalities of the heart, head, arms, or legs. It may also increase the child’s risk of developmental conditions, including autism.

Your doctor will likely recommend that you don’t take Depakote or Depakote ER if you’re pregnant or planning to become pregnant. If you can become pregnant, your doctor will recommend using effective birth control during Depakote or Depakote ER treatment.

If Depakote or Depakote ER are the only medications that work to control your seizures, your doctor may prescribe the drug even if you’re pregnant or planning pregnancy. In this case, you and your doctor will discuss your treatment plan and the risks and benefits of Depakote treatment.

If you become pregnant while taking Depakote or Depakote ER, you could consider enrolling in the pregnancy registry for antiepileptic drugs. A pregnancy registry helps gather information about how a drug can affect pregnancy.

For more information about the North American Antiepileptic Drug Pregnancy Registry, talk with your doctor. You can also call 888-233-2334 or visit the registry’s website.

Talk with your doctor if you have questions about Depakote or Depakote ER and pregnancy.

Breastfeeding

Depakote and Depakote ER are known to pass into breast milk if taken while breastfeeding. These drugs may cause side effects in a child who’s breastfed. Side effects may include unusual bruising or bleeding, and jaundice (yellowing of the skin or the whites of the eyes).

Talk with your doctor about feeding options for your child if you’re prescribed Depakote or Depakote ER. Together you can discuss risks and benefits of Depakote treatment while breastfeeding. If you are breastfeeding while taking Depakote or Depakote ER, be sure to watch for any side effects in the child.

Like most medications, taking Depakote or Depakote ER can result in side effects. In most cases, side effects are mild. But serious side effects are possible.

If you’re considering treatment with Depakote or Depakote ER, talk with your doctor. Ask questions that help you feel comfortable with your treatment choices. Some examples to help get you started are:

  • Can Depakote or Depakote ER cause side effects related to the nervous system, such as hallucinations or tardive dyskinesia?
  • Are there treatments I can take for the common side effects of Depakote or Depakote ER?
  • How do the side effects of Depakote and Depakote ER compare with other medications that might treat my condition?
  • If I have side effects while taking Depakote or Depakote ER, will I need to stop taking it?

If you have bipolar disorder, consider signing up for Healthline’s online newsletter for advice on mood management and mental wellness.

Healthline also has a migraine newsletter that delivers guidance on treating this condition to your email inbox. You can also find support and advice in our Bezzy migraine community.

Q:

Are there blood tests that can monitor for side effects of Depakote or Depakote ER?

Anonymous

A:

Yes, your doctor will likely recommend certain blood tests during your treatment. You’ll have liver function tests to monitor for liver damage. Your doctor may also order tests to check your blood cell counts to determine your risk of bleeding problems with Depakote or Depakote ER.

You might also have tests to check your blood levels of valproic acid and ammonia. (The active drug in Depakote and Depakote ER, divalproex sodium, is a form of valproic acid). Your doctor might recommend this if you become sick or start having serious side effects during treatment

Your doctor or pharmacist can tell you more about blood tests you can expect to have during Depakote or Depakote ER treatment.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Depakote side effects and safety information

Depakote treats a variety of conditions but it can produce side effects such as tremors, weight changes, hair loss, and depression

Depakote side effects | Tremors | Weight changes | Rash | Depression | Hair loss | Sexual side effects | How long do side effects last? | Warnings | Interactions | How to avoid side effects

Depakote is a brand-name prescription medicine for the generic drug divalproex sodium or valproic acid. Depakote is in a class of medications called antiepileptic drugs, or anticonvulsants. It works by calming hyperactivity in the brain. It is approved by the Food and Drug Administration (FDA) to prevent and treat seizures, especially in people with epilepsy. Depakote is generally recommended for adults and children 10 years of age and older. It is also used to treat manic episodes associated with bipolar disorder, and to prevent migraine headaches. 

Depakote has a black box warning for hepatotoxicity and should not be taken by people with liver problems. It can cause serious pancreas damage, so people with a history of pancreatitis should not take it. Pregnant women should not take Depakote either. Like any other medication, it is important to be aware of Depakote side effects and its interactions. Let’s look at what you need to know before taking Depakote. 

RELATED: What is Depakote? 

Common side effects of Depakote

Like all medications, Depakote may cause minor and temporary side effects. In patients taking Depakote, the most common side effects include:

  • Headache
  • Nausea
  • Tiredness
  • Swelling of the arms and legs
  • Loss of appetite
  • Abdominal pain 
  • Skin rash
  • Weight gain
  • Vomiting 
  • Weakness
  • Hair loss
  • Tremor
  • Diarrhea 
  • Blurred vision
  • Increased appetite 
  • Decreased platelet count 
  • Confusion
  • Lightheadedness 

Tremors

Tremors are a known side effect of Depakote. According to a study, about 4% of patients taking Depakote report developing a tremor, which may affect the hands, arms, head, or eyelids. In rare cases, the lower body is affected. The tremor may not affect both sides of the body equally. If patients develop a tremor and it is affecting their ability to function or their quality of life, they should discuss dosage options with their healthcare provider. Tests may be done to rule out other causes of a tremor.

Weight changes 

Depakote often causes an increased appetite, which can lead to weight gain. People taking it to treat migraine headaches may have decreased serotonin levels, which can also lead to cravings and overeating. Depakote can also cause drowsiness, which may decrease activity level. If weight gain is a concern, patients are encouraged to eat a balanced diet and engage in regular physical activity. If the weight gain continues, patients can discuss other medication options with their healthcare provider. 

Rash

A mild rash is a common side effect of Depakote and is often not of concern. However, patients should seek immediate medical attention if they develop fever, a red or purple skin rash, hives, sores in the mouth, blistering and peeling of the skin, swelling of the lymph nodes, swelling of the face, eyes, lips, tongue, or throat, trouble swallowing or breathing, as these may be signs of a serious allergic reaction.  

Serious side effects of Depakote

Some side effects of Depakote are more serious and may require medical attention. These include:

  • Pancreatitis
  • Severe liver damage 
  • Suicidal thoughts and depression
  • Severe rash
  • Rapid weight gain
  • Elevated ammonia in the blood
  • Hypothermia (low body temperature) 
  • Bleeding problems 

Depression

Patients taking anticonvulsants for any reason may develop depression, and people with a history of mental illness are at an increased risk of worsening depression while taking Depakote. Patients should talk to their healthcare provider if they notice an increase in depressed thoughts, suicidal thoughts, new or worsening irritability, new or worsening anxiety, panic attacks, trouble sleeping, dangerous impulses, or other changes in their mood or behaviors. 

Other Depakote side effects

Hair loss

According to one study, Depakote has been reported to cause hair loss in less than 3% of patients taking it. It is primarily reported in women who are between 40 and 49 years old. If patients are concerned about Depakote and hair loss, they should discuss this with their healthcare provider. Lowering the dosage of Depakote may alleviate this symptom.

Sexual side effects

Depakote interferes with the endocrine system and, according to one study, can cause reproductive and sexual dysfunction in both men and women. The most common sexual side effects were erectile dysfunction and decreased libido. If patients experience bothersome sexual side effects, they should discuss this with their healthcare provider. 

How long do Depakote side effects last? 

Most side effects of Depakote are temporary and will go away on their own after the medication is stopped. Since everyone metabolizes medications differently, their bodies will adjust to side effects in their own way. Most common side effects, including nausea and tiredness, will improve after two to four months of taking Depakote.  

Depakote contraindications and warnings 

Liver damage

Depakote should not be taken by people with compromised liver function. It can cause serious liver damage, especially in children younger than two years of age. Children younger than 2 years and patients with hereditary mitochondrial disease are at a considerably increased risk of developing fatal hepatotoxicity. Patients should tell their healthcare provider immediately if they experience stomach pain, dark urine, yellowing of the eyes or skin, decreased appetite, itching, skin rash, vomiting, and/or swelling in their feet, as these are symptoms of liver damage. The risk of getting this serious liver damage is more likely to happen within the first six months of treatment. In some cases, liver damage may continue even after stopping the drug.

Pancreatitis

Depakote can cause pancreatitis in both children and adults, and should not be taken by people with a history of pancreas disease. Patients should tell their healthcare provider if they experience severe stomach pain, sudden change in body temperature, constipation, or lightheadedness.

Pregnancy and breastfeeding

Depakote has been known to cause serious birth defects, such as spina bifida, and should not be taken by women who are pregnant. According to the manufacturer, these defects occur in 1-2 out of every 100 babies born to mothers who use this medicine during pregnancy. Depakote should not be taken by women who plan on becoming pregnant while taking the medication.

Depakote can be passed through breast milk and should not be taken by women who are breastfeeding.

Other restrictions 

  • Some men have become infertile while taking Depakote.
  • People who have had an allergic reaction to valproate, valproic acid, divalproex sodium, or any of the ingredients in Depakote should not take it. 
  • Patients with certain metabolic diseases such as urea cycle disorders should not take Depakote. 
  • Depakote has the potential to cause blood thinning and should not be taken by people with a history of bleeding problems.

Withdrawal 

Depakote is generally not considered habit-forming. However, stopping Depakote suddenly can cause serious problems. Patients with epilepsy who suddenly stop a seizure medicine can trigger seizures that will not stop. To avoid withdrawal symptoms, patients should discuss slowly stopping treatment with their healthcare provider. Everyone reacts to medications differently, but possible withdrawal symptoms of Depakote may include seizures, dizziness, tremors, irritability, anxiety, and depression. Patients should seek medical advice if these symptoms worsen. 

Toxicity

Patients should take the dose of Depakote prescribed by their healthcare provider. While everyone responds to medication differently, the maximum recommended dose of Depakote is 60 mg/kg/day. 

It is possible to overdose on Depakote if too much is taken. Symptoms of overdose include sleepiness and irregular heartbeat. A rare symptom of an overdose is a coma. Patients should seek immediate medical attention if they take more than their prescribed dose or experience any of these symptoms.  

Depakote interactions

Like any other medication, there are certain drug interactions that should be avoided. Do not take Depakote with: 

  • Anticoagulants, such as warfarin 
  • Other anticonvulsants, including carbamazepine, ethosuximide, lamotrigine, phenytoin, phenobarbital, and topiramate
  • Antidepressants and anxiolytics, including amitriptyline, bupropion, nortriptyline, and phenelzine
  • Antiemetics, including metoclopramide and over-the-counter medications such as antacids
  • Multiple sclerosis agents, including dalfampridine and amifampridine

How to avoid Depakote side effects

1. Take Depakote as prescribed

Read all drug information before starting Depakote, and follow all directions on your prescription label. Depakote is taken orally and comes as a capsule, extended-release tablets called Depakote ER, a delayed-release tablet, a Depakote sprinkle capsule (capsule that contains small beads of medication that can be sprinkled on food), and a syrup (liquid) to take by mouth.  

Dosage will depend on a number of factors including your age, sensitivity to side effects, other medications you are taking, and the reason you are taking Depakote. Take the amount of medication that your healthcare professional has prescribed. The most common Depakote doses are 125 mg tablets, 250 mg tablets, and 500 mg tablets. Take Depakote with food to help prevent the medication from causing stomach pain. 

Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. 

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. 

Do not stop taking Depakote without talking to your healthcare provider. 

2. Discuss your full medical history with your healthcare provider

Tell your doctor of any medications you are taking, including prescription and over-the-counter drugs, vitamins, and herbal supplements. Discuss any medical conditions you have. Let them know if you are pregnant or breastfeeding or planning on becoming pregnant while taking Depakote. Tell your provider if you have a history of pancreas or liver disease, bleeding problems, or certain metabolic diseases such as urea cycle disorder. It’s also important to discuss a history of depression or mental illness and if you’ve ever experienced suicidal ideation as Depakote may increase these thoughts. While taking Depakote, tell your doctor about any side effects or other symptoms you may develop as he or she may want to adjust the dosage. 

3.  Avoid other medications and substances that could make you drowsy

Depakote may make you drowsy. Do not drive or operate heavy machinery until you know how it will affect you. Some people may also experience impairment in thinking and judgment. Do not drink alcohol while taking Depakote, as this may increase your drowsiness. Do not take sleeping pills, narcotic pain medication, or any other substance that may make you drowsy until you know how Depakote will affect you. Keep Depakote and all medications away from children.

Can drugs cause depression?

  • Alex Therrien
  • BBC health reporter

Photo credit, Getty Images

Photo caption,

Experts say doctors must provide full information about which drugs you take10

When we hear about the side effects of medications, most often the first thing that comes to our mind is a physical reaction of our body, such as a headache or a rash. nine0018

However, US scientists have provided new evidence that many prescription drugs can cause depression.

These include heart medications, oral contraceptives, and even some painkillers.

The study involved 26,000 people - and more than a third of the drugs they took provoked depression.

What does the study say?

In a study published in the Journal of the American Medical Association, researchers analyzed medical data from people who used at least one prescription drug between 2005 and 2014. nine0011

In 37% of the drugs taken by the subjects, depression was among the side effects.

  • Is fast food a sure way to depression?
  • If you are a woman, will you get quality health care?

Moreover, those who took only one drug with such a possible side reaction, the risk of developing depression increased by 7%. For those who took two drugs - by 9%, and for those who took three drugs - by 15%.

"It will surprise many that their medications, despite the fact that they may have nothing to do with mood changes or any other condition that is commonly associated with depression, can increase the risk of depressive symptoms and even lead to a diagnosis of depression" - notes Dima Kato of the University of Illinois, who led the research. nine0011

At the same time, it should be noted that any illness can negatively affect mood. In addition, some participants in the study may have experienced depression before.

What do other experts say?

British experts point out that a study by their American colleagues indicates a link between drugs and an increased risk of depression, but not that drugs can be the cause of this condition.

"It is not surprising that the use of drugs to treat physical ailments, such as heart problems or lung disease, may be associated with depressive symptoms, since these physical ailments are already associated with an increased risk of depression," explains Professor David Baldwin of the British Royal college of psychiatrists. nine0011

At the same time, Prof. Helen Stokes-Lampard, chair of the Royal College of Physicians, notes that the study indicates "how important it is for patients to tell their doctors or pharmacists about all the drugs they take."

Is there a risk?

Side effects depend on the pharmacological properties of the drug. For example, depression can be a common side effect of some oral contraceptives, meaning it affects up to 1 in 10 patients. nine0011

In turn, rare side effects may occur in 1 patient in 10 thousand.

Professor David Taylor of the British Royal Society of Pharmacy says that what matters here is whether there is a "credible explanation" for why a particular drug causes depression.

  • How bacteria affect our mood
  • How hormones, immunity, microbes and pulse affect our character
mood. nine0011

In other cases, it may be difficult to determine whether a drug is causing the depression - or the illness for which it is prescribed.

What to do?

At the first sign of drug depression, immediately go to your doctor and inform about the side effect that has arisen, Professor Taylor advises.

But you also need to be careful when switching to other drugs - especially if you are taking other drugs at the same time

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Valproic Acid and Derivatives: Pediatric Medication

Pediatric Medicine

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This document, provided by Lexicomp ® , contains all the information you need to know about this medicine, including indications, directions for use, side effects, and when your healthcare provider should be contacted. nine0011

Trade names: USA

Depacon [DSC]; Depakene [DSC]; Depakote; Depakote ER; Depakote Sprinkles

Trade names: Canada

APO-Divalproex; APO-Valproic Acid; Depakene; epival; MYLAN-Divalproex; PMS-Valproic; PMS-Valproic Acid; SANDOZ Valproic [DSC]; TEVA-Divalproex [DSC]

Warning

All Forms:
  • The use of this drug was accompanied by violations of the liver. In some cases, these violations have led to death. In most cases, liver problems occurred within the first 6 months after starting this drug. Call your child's doctor right away if your child shows signs of liver problems such as dark urine, fatigue, lack of appetite, nausea or abdominal pain, light-colored stools, vomiting, yellowing of the skin or eyes. In patients suffering from seizures, there may be a loss of control over seizures. Do your child's blood test as directed by their doctor. nine0004
  • The risk of life-threatening liver problems is increased in children under 2 years of age. The risk is highest in patients taking more than 1 anti-seizure drug or who have a metabolic disorder, severe epilepsy with mental retardation, or congenital brain disease. Consult your doctor.
  • Patients with a genetic liver disorder are at an increased risk of developing liver failure due to a mitochondrial disorder such as Alpers-Huttenlocher syndrome. Your child may need genetic testing to detect this disease. If a child has or may have a mitochondrial disorder, do not give this drug without consulting your doctor. nine0004
  • This drug can cause serious and sometimes deadly problems with the pancreas (pancreatitis). Such a violation can occur in children at any time during treatment with this drug. Symptoms of pancreatitis include abdominal pain, nausea, vomiting, or decreased appetite. If your child develops any of these symptoms, contact their doctor immediately.
If your child is or may be sexually active:
  • If your daughter is pregnant or may become pregnant, check with her doctor to make sure this drug is right for her. She must use birth control while taking this drug to prevent pregnancy. nine0004
If your daughter is pregnant or likely to be pregnant:
  • This drug can cause serious birth defects if taken during pregnancy. It can also lower a child's IQ and may increase the risk of autism or ADHD. If your daughter becomes pregnant while taking this drug, call her doctor right away.
  • Do not give this migraine prevention drug to your daughter if she is pregnant or not using birth control to prevent pregnancy. nine0004
All oral preparations:
  • This drug comes with a separate patient information leaflet called Patient Drug Information. Read it carefully each time you take this drug. If you have any questions about this drug, ask your doctor, pharmacist, or other health care professional.

What is this drug used for? nine0107

  • Used to treat seizures.
  • It is used to prevent migraine.
  • This medicine is used to treat bipolar disorder.
  • This drug can be given to children for other indications. Consult your doctor.

What do I need to tell the doctor BEFORE my child takes this drug?

  • If your child has an allergy to this drug, any of its ingredients, other drugs, foods, or substances. Tell the doctor about the allergy and how it manifested itself in the child. nine0004
  • If your child suffers from any of the following: liver disease or a urea cycle disorder.

This list of drugs and conditions that may interact with this drug is not exhaustive.

Talk to your doctor or pharmacist about all medicines your child is taking (prescription and over-the-counter, natural, and vitamins) and any health problems. You need to make sure that this drug is safe to use for your child's illnesses and in combination with other drugs he or she is already taking. Do not start, stop taking, or change the dosage of any drug your child is taking without the doctor's approval. nine0011

What do I need to know or do while my child is taking this drug?

For all uses of this drug:
  • Tell all health care providers who care for your child that your child is taking this drug. These are your child's doctors, nurses, pharmacists and dentists.
  • Have your child avoid tasks or activities that require attention until you see how this drug works for your child. This includes cycling, playing sports, or using items such as scissors, lawn mowers, electric scooters, toy cars, or motorized vehicles. nine0004
  • Perform blood tests as directed by your doctor. Consult with your doctor.
  • Alcohol can interact with this drug. Make sure your child does not drink alcohol.
  • Check with your child's doctor before using marijuana, other forms of cannabis, or prescription or over-the-counter drugs that may slow your child's progress.
  • This drug may affect the results of some lab tests. Tell all health care workers and laboratory workers who provide your child's health care that your child is taking this drug. nine0004
  • If your child is unable to eat or drink as usual, check with their healthcare provider. These situations include illness, fasting, certain procedures or surgery.
  • Some brands of this drug contain peanut butter. If your child is allergic to peanuts, ask your pharmacist to check the peanut butter content of your child's brand of peanut butter. nine0004
  • Your child may become more prone to bleeding. Make sure your child is careful to avoid injury. Make sure your child uses a soft toothbrush.
  • This drug has been associated with increased levels of ammonia in the blood. This can lead to certain brain disorders. Some fatalities. Consult your doctor.
  • In some individuals, certain brain disorders were not accompanied by an increase in the level of ammonia in the blood. In some cases, these brain disorders resolved after discontinuation of treatment with this drug. However, in some cases they did not go completely. Consult your doctor. nine0004
  • There was a serious reaction that could be deadly. In most cases, this reaction was accompanied by symptoms such as fever, rash, inflammation of the lymph nodes, and dysfunction of various organs such as the liver, kidneys, blood, heart, muscles, joints and lungs. If you have any questions, please consult your doctor.
  • This drug may affect a man's ability to have a child. Consult your doctor. nine0004
If your daughter is breastfeeding:
  • Tell your doctor if your daughter is breastfeeding. You will need to be counseled about the possible risks to the child.
Anti-seizure:
  • Talk to your doctor if your seizures change or get worse after you start taking this drug.

What side effects should I report to my child's doctor right away?

WARNING/CAUTION: Although rare, this drug can cause very serious and sometimes deadly side effects in some people. Call your child's doctor right away or seek medical attention if your child has any of the following signs or symptoms that could be associated with a very bad side effect:

  • Signs of an allergic reaction, such as rash, hives, itching, red and swollen skin with blisters or peeling, possibly accompanied by fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue or throat. nine0004
  • Signs of infection, such as fever, chills, very bad pain in the throat, ear, or sinuses, cough, more sputum or change in color, pain when urinating, mouth sores, or a sore that doesn't heal.
  • Signs of high ammonia levels such as irregular heartbeat, trouble breathing, confusion, pale skin, bradycardia, seizures, sweating, vomiting, or muscle twitches.
    • 9009five Chest pain.
  • Swelling of the hands or feet.
  • Vision change.
  • Impairment or loss of memory.
  • Balance change.
  • Difficulties with walking.
  • Any unexplained bruising or bleeding.
  • The appearance of purple spots on the skin or redness of the skin.
  • Difficulty urinating or a change in the amount of urine produced.
  • Swelling of the gland.
  • Muscle pain or weakness. nine0004
  • Pain or inflammation in the joints.
  • Shiver.
  • Loss of control over eye movements.
  • Tinnitus.
  • Chills.
  • Like other seizure medicines, this medicine can rarely increase the risk of suicidal ideation or behavior. This risk may be higher in people who have tried or had suicidal thoughts in the past. Call your doctor right away if you develop or worsen symptoms such as depression, nervousness, anxiety, irritability, panic attacks, or other mood or behavioral disturbances. If you have suicidal thoughts or attempted suicide, contact your doctor immediately. nine0004

What are some other side effects of this drug?

Any drug can cause side effects. However, for many people, side effects are either minor or non-existent. Contact your child's doctor or seek medical attention if any of these or other side effects bother your child or if they persist:

  • Headache.
  • Constipation, diarrhea, abdominal pain, nausea, vomiting, or decreased appetite. nine0004
  • Increased appetite.
  • Feeling dizzy, tired or weak.
  • Sleep disorders.
  • Weight gain or loss.
  • Hair loss.
  • Nervous tension and agitation.
  • Flu-like symptoms.

This list of possible side effects is not exhaustive. If you have any questions about side effects, ask your child's doctor. Talk to your child's doctor about side effects. nine0011

You can report side effects to the National Health Office.

What is the best way to give this drug?

Give this drug to your child as directed by your doctor. Read all the information provided to you. Strictly follow all instructions.

All oral preparations:
  • Give this drug with or without food. If the drug causes stomach upset, give it with food. nine0004
  • Keep giving this drug as directed by your child's doctor or other health care provider, even if your child is feeling well.
  • Do not stop giving this drug to your child abruptly without talking to the doctor. This can increase the risk of seizures. If needed, this drug should be stopped gradually for your child as directed by the doctor.
    • nine0095 If your child is taking cholestyramine, you may need to give it at a different time than this drug. Consult with a pharmacist.
Tablets and capsules:
  • Ask your child to swallow whole. Ask your child not to chew, break, or crush the tablet.
  • Give this drug with a full glass of water.
  • If your child has difficulty swallowing, check with your doctor. nine0004
Long acting tablets:
  • If you or your child see particles of this drug in your child's stool, contact your doctor.
Split capsule:
  • The child may swallow the capsule whole or mix the contents of the capsule with certain foods such as applesauce. Make sure the child takes the mixture immediately. Do not store for future use.
  • If you or your child see particles of this drug in your child's stool, contact your doctor. nine0004
Fluid:
  • Liquid doses should be measured with caution. Use the dispenser that comes with the medication. If the dispenser is not provided in the package, ask the pharmacist for a dosing agent for this drug.
Injection:
  • This drug is administered by infusion intravenously continuously for a certain time.

What if my child misses a dose of medication? nine0107

All oral preparations:
  • Give the missed dose as soon as possible.
  • If it is time for your child to take the next dose, do not take the missed dose and then go back to your child's normal schedule.
  • Do not give a double dose at the same time or additional doses.
Injection:
  • Contact your child's doctor to find out the next steps.

How do I store and/or discard this drug? nine0107

All oral preparations:
  • Store at room temperature in a dry place. Do not store in the bathroom.
Injection:
  • If you need to store this drug at home, check with your child's doctor, nurse, or pharmacist about how to store it.
All forms:
  • Keep all medicines in a safe place. Keep all medicines out of the reach of children and pets. nine0004
  • Dispose of unused or expired drugs. Do not empty into a toilet or sewer unless instructed to do so. If you have any questions about disposing of medicines, ask your pharmacist. Drug disposal programs may be in place in your area.

General information about medicines

  • If your child's symptoms or health problems do not improve, or worsen, contact your child's doctor. nine0004
  • Do not share your child's medicine with others and do not give anyone else's medicine to your child.
  • Some medicines may come with other patient information leaflets. If you have questions about this drug, talk with your child's doctor, nurse, pharmacist, or other health care professional.
  • If you think you have overdosed, call a poison control center or get medical help right away. Be prepared to tell or show what drug you took, how much, and when it happened. nine0004

Consumer Use of Information and Limitation of Liability

This summary information includes a summary of the diagnosis, treatment, and/or drug product. It is not intended to be a comprehensive source of data and should be used as a tool to help the user understand and/or evaluate potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a particular patient. It should not be considered medical advice or a substitute for medical advice, diagnosis or treatment provided by a physician based on a medical examination and assessment of the patient's specific and unique circumstances. Patients should consult with their physician for full information about their health, medical issues, and treatment options, including any risks or benefits regarding the use of medications.

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