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Patients, their caregivers, and families should be counseled that AEDs, including Depakote, may increase the risk of suicidal thoughts and behavior and should be advised of the need to be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm.
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Taking both Depakote and another seizure medicine, Klonopin, sometimes causes absence seizures to be much longer.
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The Food and Drug Administration (FDA) approved divalproex for the acute treatment of mania in the 1990's.
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As a result of inadequate warnings, Depakote has been used by many pregnant women, resulting in devastating birth defects and malformation for children throughout the United States.
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Although not studied, an interaction of topiramate and valproic acid may exacerbate existing defects or unmask deficiencies in susceptible persons.
Because of these changes in valproate clearance, monitoring of antiepileptic concentrations should be intensified whenever concomitant antiepileptics are introduced or withdrawn.
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Experience has indicated that pediatric patients under the age of two years are at a considerably increased risk of developing fatal hepatotoxicity, especially those with the aforementioned conditions (see BOXED WARNING).
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Be sure to mention the medications listed in the IMPORTANT WARNING section and methotrexate (Rheumatrex, Trexall); other medications for seizures such as carbamazepine (Tegretol), oxcarbazepine (Trileptal), phenobarbital (Luminal, Solfoton), phenytoin (Dilantin), and primidone (Mysoline); pyrimethamine (Daraprim); rifampin (Rifadin, Rimactane); and trimethoprim (Proloprim).
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Many parents on the BPParents listserv (an on-line community of parents who communicate with each other from all over the world via E-mail) reported that their children experienced psychosis and were hospitalized subsequent to their treatment with antidepressants.
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Tell your doctor if your seizures persist, change, or worsen.
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Over the coming weeks, we will be covering several of the most common anti-seizure meds used to treat bipolar-disorder-related symptoms, including Depakote (valproic acid), Lamictal (lamotrigene), Tegretol (carbemazapine), Trileptal (oxcarbazepine), Topomax (topiramate), and Neurontin (gabapentin).
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There is an increased risk of liver failure and death from liver failure in patients who have a genetic liver problem caused by a mitochondrial disorder (eg, Alpers-Huttenlocher syndrome).
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