Depakote--your thoughts

[hootie]

My son has been on Depakote since December. At 1/2 dose (125 mg twice a day. He was working up to 250 mg twice a day), his absence seizures went away...UNTIL he went for an MRI with anesthesia. He started having absence seizures again...I upped his dose to 125 mg three times a day (3/4 dose) and his seizures went away...UNTIL allergy season started then the seizures came back. They did go away while we were in Florida for spring break but came back once we returned home. The allergy season lasted about 2 months for him this year...UGH!

Now the seizures still are happening but his teacher and I noticed that he is having them at the same time each day (most likely when the depakote levels are highest in his body). He is taking 125mg at 7 am, 125mg at 12:30 pm, and 125mg at about 9:00 pm. He seems to have the seizures around 1:30 to 2:30 in the afternoon.

He had a 24 hour EEG from Friday afternoon to Saturday afternoon. We will have the results in a few weeks and may have to get him to the full dose but it just seems weird that it controls the seizures for a while and then something sets them off again.

I have a call into his doctor. Do you think he could he be having seizures from depakote???

onder:

 

[epileric]

I don't think the depakote would cause seizures unless maybe if he were overdosing (I know overdosing on tegretol causes seizures). Does he have something to eat in the morn with the depakote? If not maybe eating something would help.

I am wondering if his seizures stopped when you went to Florida, would your medical insurance cover you to move there for medical reasons?

 

[hootie]

Epileric--

His seizures are after lunch (after his second dose of depakote). Maybe it is something he is exposed to at lunch or during recess???

Your Florida comment made me laugh. Although I like Florida for spring break, I think I would die if I lived there full-time:roflmao:. I can't stand the heat and humidity.

 

[epileric]

I"m trying to remember where it was but I read that with the exception of certain allergies, it takes about 3-4 hours for your body to react to ingested foods or medications. That's why I wondered about the morning dose.

 

[drarvindr]

Not that i've ever heard of. Have looked it up . no studies.
As for why the valproate isn't working either:
a) he's not responding to it
b) he doesn't have the required blood levels ( have you got a serum valproate level?)
or c) he's eating something that prevents him from utilizing the valproate ( such as grapefruit juice or St John's wort) . Other herbal remedies have been known to interfere with the cytochrome P450 pathway and these could be responsibe. Some veggies also have similar issues ( look it up online . its on
http://csuvets.colostate.edu/pain/Articlespdf/Herbs%20and%20Foods%20that%20Alter%20Drug%20Metabolism.pdf) I've looked in journals and so far no evidence of seizure frequency increasing from valproate. You have to realize that were this a recognised side effect the drug would be off the market.

I hope i've been of help
Hope he gets better - all the best
Arvind

 

[hootie]

I spoke with the nurse at the office yesterday. She told me that the doc wants me to increase my son's dose by 125mg. I knew she would say this.

I hope he does not get the crabbies again after increasing the dose and that the seizure activity stops for good.

I was wishing that the neruofeedback would have helped with the seizure activity by now so that we could slowly wean him off the drugs. Oh well...at least he seems more "with it" and is talking a little more.

 

[hootie]

The nurse called today with *some* info on my son's EEG report. She said his seizure activity is reduced, but she did not (was not?) able to comment on the amount of reduction.

She said the doc wants me to double his dose from 1 cap three times a day (125mg each) to two caps three times a day...and to not gradually do it but to just double it. Has anyone increased this quickly before? He had trouble (crabbies) going from one cap twice a day to one cap three times a day.

I think I will just increase one at a time and see how it goes...

I hate to see how much weight he will gain with the double dose.

 

[Nakamova]

I agree that slower is better, despite what your doc says.

 

[lindinig]

Have you had his depakote levels checked? We increased my son's depakote dose by 500 mg (he's on the ER version), and it caused him to totally disconnect from the world. We had his levels checked after the increase, and his levels were too high. We reduced it slightly, had his levels checked again, and they were in the normal range.

You might also want to ask the neurologist about the ER (extended release) version of Depakote. I give this to my son every night, and it does a pretty good job of keeping his absense seizures away. Maybe the drop in levels and the sudden increase in levels (with the second dose) may be what's causing the seizure.

We're waiting to have our first neurofeedback appt. I really, really hope I can reduce his medicine.

 

[hootie]

I was trying to avoid increasing as I want to wean him off the meds eventually. His level was slightly low at 125mg three times a day.

I will look at the ER version...but with the multiple food allergies and chemical sensitivities it might be hard for him to take this one.

We will have his follow-up NFB appt on the 27th. This will cover the QEEG results after 40 sessions of neurofeedback.

 

[tripletdad]

I was on depakote since it came our in 83. It helped with the grand mal seizures, and to a good extent, the absence or petite mal seizures (i am dating myself). Finding the right drug and dosage was always a constant struggle but dont evern give up the efforts will be worth it. IMHOP

I found that the more diligent I was with sleep, exercise, and taking care of my body the better results I got.