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Depakote® ER is the brand name of valproic acid, a medication used to control seizures in patients with epilepsy. It is also known by the names divalproex sodium and sodium valproate. Depakote® ER is manufactured in the United States by Abbott Laboratories. It is available as 250-mg and 500-mg oval-shaped tablets.
The ER in Depakote® ER stands for extended-release. This refers to the tablet formulation, which slowly releases the drug over a 24-hour period of time. Patients only have to take an extended-release tablet once a day, while other forms and brands of valproic acid must be taken at least twice a day to be effective.
For the treatment of epilepsy, Depakote® ER is thought to work by increasing concentrations of compound called gamma amino-butyric acid (GABA) in the brain. It may be used by itself or in combination with other anti-seizure medications. Patients with epilepsy should not stop taking Depakote® ER without asking their physician first. Suddenly stopping taking it may lead to an increased risk of seizures.
Although Depakote® ER is primarily used as an anti-seizure medication, it has other indications as well. Patients with bipolar disorder often take this medication to treat manic episodes. In addition, Depakote® ER has been found effective in the prevention of migraine headaches. It is not known exactly how it works for these other indications. If patients are taking Depakote® ER for migraine prevention, they need to know that it is not a pain medication and will not treat a migraine, once it occurs.
All medications have side effects, and Depakote® ER is not an exception. The most common side effects include headache, nausea or vomiting, drowsiness, and dizziness. All of these may occur in up to one-third of patients. Taking the drug with food helps to minimize nausea and vomiting.
Drowsiness and dizziness can be partially avoided by starting at a low dose, then slowly increasing the dose over several weeks. Both diarrhea and constipation have been reported in patients taking Depakote® ER, although diarrhea seems to be more common. Finally, increased appetite, weight gain, and visual changes, such as seeing double and blurry vision, have been reported by five to ten percent of patients.
The common side effects of Depakote® ER are usually fairly mild. There are other side effects, however, which occur much less often but can be severe and life threatening. The most important is damage to the liver. This usually occurs in the first six months of treatment and is more common in children under the age of two years, patients who already have liver disease, and patients taking other anti-seizure medications.
Depakote® ER can also lead to a decreased number of platelets. This is called thrombocytopenia, and it increases the risk of bleeding and bruising. Lastly, Depakote® ER can cause damage to the pancreas. Although this is usually reversible, it often requires that the patient be hospitalized. All of these serious side effects can and should be monitored for with blood tests.
There are several other important facts to remember when taking Depakote® ER. The tablets should be swallowed whole, never crushed or chewed. Crushing or chewing a tablet will destroy the extended-release component, leading to release of an entire daily dose at once. Women who are pregnant should not routinely take Depakote® ER. It may cause adverse effects in the developing baby.
Drinking alcohol while taking Depakote® ER is also not recommended. This increases the risk of drowsiness and dizziness. Depakote® ER interacts with many other prescription and over-the-counter medications. Patients taking this drug should always ask their doctor or pharmacist before starting or stopping any other medication.