No medication works for everybody, and it is not unusual to have to try several medications before you find the one that works. Additionally, the necessary dose varies greatly from person to person. This should be discussed with your doctor.
Anticonvulsant
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Dr. Steven A. Meyers, MD , Diagnostic Radiology, answered on behalf of NorthShore University HealthSystem -
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International Bipolar Foundation answeredAn anticonvulsant, valproic acid may increase levels of the male hormone testosterone in young women under 20. Increased testosterone can lead to polycystic ovarian syndrome (PCOS) in women. Because PCOS causes a woman's eggs to turn into cysts (fluid filled sacks), infertility can result. Unlike the process in a woman without PCOS, eggs are not released monthly, but remain in the ovaries.
When doctors and families determine that valproic acid is the best medication for the individual, the doctor will monitor the ovaries for the onset of PCOS. If indeed PCOS does result, the doctor will most likely stop treatment with valproic acid. Most PCOS symptoms improve and/or disappear after stopping valproic acid use. -
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International Bipolar Foundation answeredValproic acid, lamotrigine (Lamictal) or divalproex sodium (Depakote), known as "anticonvulsants," have proven to help stabilize moods. Initially developed to treat seizures, some anticonvulsants have proven more effective in children than lithium. These medications have not been approved by the Food and Drug Administration (FDA) to treat bipolar disorder in children, yet, but if you keep checking at the FDA site, something similar may. Further, doctors can sometimes get around these restrictions if the situation warrants it.
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International Bipolar Foundation answeredCommon side effects of divalproex (brand name Depakote) for bipolar disorder include sedation, weight gain, tremor, and gastrointestinal problems. Blood level monitoring and dose adjustments may help minimize side effects. Divalproex may cause a mild liver inflammation and may affect the production of a type of blood cell called platelets.
Although it is quite rare for there to be any serious complications from these potential effects, it is important to monitor liver function tests and platelet counts periodically. -
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Dr. Darria Gillespie, MD , Emergency Medicine, answeredSee All 2 AnswersYour doctor will need to assess your liver function before starting treatment. Serum bicarbonate will need to be measured before starting topiramate.
If you take topiramate, you should avoid alcohol.
Valproic acid and topiramate are passed into breast milk and may not be good options for breastfeeding women.
If you have kidney function impairment or liver function impairment, valproic acid and topiramate may not be good options for you.
If you have urea cycle disorder, you should not take valproic acid.
If you are pregnant, planning to become pregnant, or may be pregnant, these anticonvulsants should be avoided. The health of your baby may be at risk if you take topiramate or valproic acid.
This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor. -
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Dr. Darria Gillespie, MD , Emergency Medicine, answeredSee All 2 AnswersValproic acid and topiramate have been considered the top choices among anticonvulsants for reducing migraine frequency. Valproic acid reduces the number of migraines by about 4 per month. Topiramate reduces migraines by about 1 per month. More research is needed to know for sure if carbamazepine or gabapentin is effective. Most other anticonvulsants have not been found to reduce migraine frequency.
This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor. -
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Common side effects include numbness and tingling in the hands or feet, slowed reactions, difficulty concentrating, difficulty thinking of specific words, memory problems, altered taste sensation, nausea and weight loss. -
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Dr. John Preston, PsyD , Psychology, answeredSee All 2 AnswersAnticonvulsants can interact adversely with the following medications. Interactions vary depending on the specific anticonvulsant.- birth control pills (especially with Tegretol; may occur with Topamax, a medication that does not treat bipolar symptoms but is commonly prescribed to bipolar patients to reduce weight gain)
- anticoagulants
- aspirin (moderate to high doses)
- cimetidine (Tagamet)
- antibiotics (especially with Tegretol)
- calcium channel blockers
- propoxyphene (Darvon; especially with Tegretol)
- antidepressants (high doses)
- antacids (may affect the absorption of some anticonvulsants)
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Dr. Egilius L. Spierings, MD , Neurology, answeredSee All 2 AnswersThe anticonvulsant, or antiseizure medication, divalproex (Depakote) tends to be about as effective as calcium-channel blockers (medication for high blood pressure, heart disease and migraine) in migraine prevention, although it's not as well tolerated. Its side effects can include nausea, diarrhea, weakness, weight gain, and tremor. Very rarely, it can cause potentially fatal liver failure. Consequently, people with liver disease shouldn't take this medication, and anyone who takes divalproex should have regular liver function tests. Women who are pregnant or trying to become pregnant shouldn't take this drug.
Topiramate (Topamax) and gabapentin (Neurontin) don't impair liver function, but these medications have other side effects to consider. One risk to keep in mind: topiramate may encourage the formation of kidney stones, so people taking it should drink plenty of fluids. Even so, topiramate and gabapentin offer an alternative for people who cannot tolerate or do not respond to divalproex.