Is it safe to take Depakote for bipolar disorder?

Depakote has been a mainstay in the treatment of bipolar disorder. Depakote does not have issues with kidney damage. However, it is metabolized in the liver, and liver damage can occasionally occur. Similarly, it can occasionally result in bone marrow damage which presents as a drop in the number of infection-fighting white blood cells called neutrophils. Depakote blood levels are important. Laboratories typically define therapeutic Depakote levels as between 50 and 100 ng/dl, and will flag a level above 100 as potentially toxic. That said, those of us who treat a lot of bipolar patients sometimes find that we need blood levels in the 100 to 120 ng/dl range. In most people this is well-tolerated. If a physician has to achieve these higher levels, one may run into the situation where a primary care provider is unfamiliar with this practice and panics when he sees it. Such concerns should be referred to the psychiatrist.

Depakote side effects include the potential for sedation and weight gain. Weight gain can be a reason that we have to stop Depakote. Also, Depakote can lead to polycystic ovarian disease in women. It seems that Depakote is only infrequently effective in treating the depressed phase of bipolar disorder.

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