Divalproex is a medication available for treating seizures, bipolar mania, and migraine. It is also known by the trade name Depakote®. The drug acts on levels of Gamma-Aminobutyric Acid (GABA) in the brain to regulate and stabilize electrical signals. Dosage recommendations depend on the condition and usually require a period of titration where the dosage is increased over time to see how the patient responds, checking blood serum levels to reach the desired concentration.
In the treatment of patients with epilepsy, divalproex can help with the prevention of seizures. It is typically used as monotherapy, without combination with another medication. The drug also has mood stabilizing effects which can be useful in the management of bipolar disorder. It may be used in combination with other psychiatric medications, such as antidepressants to manage depressive episodes, depending on the specifics of a patient’s case. Migraine patients may use divalproex to reduce the frequency and severity of migraines.
This medication must be used under careful supervision to control the dose and identify side effects early. It has known hepatic effects, and can lead to severe complications, particularly in the first six months of use. The patient may need to have several blood tests to check serum levels of the drug and make sure liver enzymes are not unacceptably high. Once the patient appears to be responding to the medication, the dosage can be leveled off, and testing may not need to be as frequent.
Common divalproex side effects can include gastrointestinal discomfort, fatigue, and dizziness. In addition to liver problems, some patients also develop pancreatitis. The drug is also linked with birth defects, which makes it important for women who are able to become pregnant to use birth control while taking it. Patients who get pregnant or are planning to become pregnant can discuss stopping the medication, which usually requires slowly stepping the dosage down to give the brain time to adjust. Abruptly stopping can cause complications, and is not generally recommended.
Other medications can interact with divalproex. Patients may need to be careful with aspirin and other blood thinners, particularly if they need extended therapy. Some antibiotics conflict with the drug, as can sedatives. Divalproex itself can have a sedating effect, especially when patients first start taking it and need to adjust, making it advisable to avoid additional sedatives until a patient is familiar with the drug. Pharmacists and other medical professionals can review a patient’s medication history to determine if there are potential drug interactions which should be addressed.