# How quickly/slowly does Depakote work?



## TheoBobTing (Jul 8, 2010)

I've been prescribed Depakote. I think my doctor prescribed it because my mood varies a lot between neutral and depressed, sometimes quite quickly. Also, one of the antidepressants I took made me more irritable and somewhat unstable. I've never had full blown mania, though I *may* have had one spell of hypomania long before trying meds (not 100% sure about that though).

Usually I don't experience hypomania. Aren't mood stabilizers better at treating mania/hypomania than depression?

This medicine does seem interesting though, because it is is thought to work by increasing levels of GABA. I have wondered if I'm a bit low on GABA. Substantial benzo doses don't affect me, and I wonder if that is because I have low GABA levels. After all, benzos can only work properly where GABA is binding to its receptor site. Thus, low GABA could lessen the effects of a benzo, no? There could be other explanations though, of course.

Anyway, how long does it take for Depakote to do its thing?


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## hoodsurgeon (Sep 18, 2011)

Depakote (semisodium valproate) is used to treat acute mania and i guess hypomania, however as far as i understand it doesn't treat any depressive symptoms (unlike lamictal). 

Also it probably will take about 1 week or 2 before it has an effect, but im not sure about this so please correct me if im wrong.


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## ourwater (Jun 2, 2012)

It doesn't treat the psychosis. I haven't taken it myself.


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## jim_morrison (Aug 17, 2008)

TheoBobTing said:


> This medicine does seem interesting though, because it is is thought to work by increasing levels of GABA. I have wondered if I'm a bit low on GABA. Substantial benzo doses don't affect me, and I wonder if that is because I have low GABA levels. After all, benzos can only work properly where GABA is binding to its receptor site. Thus, low GABA could lessen the effects of a benzo, no? There could be other explanations though, of course.


Yes, to my understanding your assertion is correct, this medication does help to build up GABA levels (by the same mechanism as Nardil, incidentally) instead of just enhancing whats already there as a benzo would. 
I'd guess give it a few weeks at a therapeutic dose, and you should be able to see if it's having any effect on your anxiety/mood swings.


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## TheoBobTing (Jul 8, 2010)

I'm a couple of days in, and so far this stuff is like water to me. Very mild. I'm thinking of pumping the dose up of my own accord. I understand that it can take a couple of weeks to work for mania (which I don't have), but for epilepsy it says 2-4 days. From a social anxiety perspective, I have no idea how long to wait.

I found a couple of neat little graphs showing how extremely low (or extremely high) levels of GABA can account for benzo inefficacy. Apparently, in a very low GABA scenario, Barbituates are MUCH more effective than benzos, but in an extremely high GABA scenario, neither benzos nor barbituates will have much effect.


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## jim_morrison (Aug 17, 2008)

If benzos don't work for you it could also be related to problems with metabolism.
I assume this may be the case if a sub-lingual form of the drug at the same dosage helps you a lot more than the pill form.


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## TheoBobTing (Jul 8, 2010)

jim_morrison said:


> If benzos don't work for you it could also be related to problems with metabolism.
> I assume this may be the case if a sub-lingual form of the drug at the same dosage helps you a lot more than the pill form.


This is feasible, and I'm wondering about trying to get a sublingual benzo prescribed. But aren't different Benzos metabolized in different ways? I've tried lorazepam and diazepam at substantial PRN doses and neither did anything, yet according to this chart, they are metabolized differently: http://www.pharmgkb.org/views/pathway/PA165111375.png

EDIT: I have Gilbert's syndrome, which is a common and quite tame syndrome. But could it affect drug metabolism?


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## istayhome (Apr 4, 2012)

"Benzodiazepines work by increasing the efficiency of a natural brain chemical, GABA" 
from wikipedia

I had thought that Benzo's work by crossing the blood-barrier more effectively than GABA and essentially the molecule is similar enough to gaba to work at the receptor site, i.e. a synthetic gaba. I guess I was wrong.

another wiki quote 
"Valproate is believed to affect the function of the neurotransmitter GABA in the human brain, making it an alternative to lithium salts in treatment of bipolar disorder. Its mechanism of action includes enhanced neurotransmission of GABA (by inhibiting GABA transaminase, then GABA would increase in concentration)."

So it seem that depakote works by inhibiting the gaba transporter, leading to higher concentrations in the synapse.

Unmedicated I seem to have very little gaba. So right from the start I needed pretty high doses of benzos in order for them to be effective. I'm also taking lamictal for bipolar I wonder if switching to depakote would would allow me to reduce my benzo dose. I'll talk to my psychiatrist at our next appointment. Actually it seems to be only approved for manic episodes of bipolar and I do not experience mania mostly just depression.

Sorry I can not find any information as to how long it takes it to start working.
good luck.


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## beaches09 (Feb 1, 2009)

I can't speak for it's use in mania but in the past I've found 1000mg to eradicate the agitation created by 300mg Bupropion in a matter of days. To give you an idea.


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## Darrenlogan56 (Jul 26, 2012)

I've been wondering if anybody who takes these GABA Re-uptake Inhibitor type / Mood-stabelizers/ anti epileptics can help in stabilizing and reducing severe crippling Anxiety? I've taken enough cocktails of meds now to realize that in terms of neurotransmitters it's really the GABA action that I would benefit most from. Benzodiazepines are so useful that I try and not use them regularly and only occasionally when I get them, they are GOLD standard in my experience as the ideal anti-anxiety effect I'm after. Now taking the addictive, dependent nature of them I know I can't take them long term and the nearest medication that I've gained benefit from in terms of reducing my anxiety is high doses of Lyrica. I've probably gained a tolerance now and am only now on 50mg x 2 a day, (it used to be 100mg x2 but I took too many in attempt to stem my anxiety) . If i was to write my own perscription, I'd say I would benefit from like 200mg x 4 a day, I only feel an edge taken off my Anxiety over the 150mg level and I'm thinking would I be better off on a type of medication like the Depakote or some stronger Gabaergic med? My Moods do swing in strong extreme waves also but it's mainly severe GAD/SAD. any thoughts? :/


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## istayhome (Apr 4, 2012)

Darrenlogan56 said:


> I've been wondering if anybody who takes these GABA Re-uptake Inhibitor type / Mood-stabelizers/ anti epileptics can help in stabilizing and reducing severe crippling Anxiety? I've taken enough cocktails of meds now to realize that in terms of neurotransmitters it's really the GABA action that I would benefit most from. Benzodiazepines are so useful that I try and not use them regularly and only occasionally when I get them, they are GOLD standard in my experience as the ideal anti-anxiety effect I'm after. Now taking the addictive, dependent nature of them I know I can't take them long term and the nearest medication that I've gained benefit from in terms of reducing my anxiety is high doses of Lyrica. I've probably gained a tolerance now and am only now on 50mg x 2 a day, (it used to be 100mg x2 but I took too many in attempt to stem my anxiety) . If i was to write my own perscription, I'd say I would benefit from like 200mg x 4 a day, I only feel an edge taken off my Anxiety over the 150mg level and I'm thinking would I be better off on a type of medication like the Depakote or some stronger Gabaergic med? My Moods do swing in strong extreme waves also but it's mainly severe GAD/SAD. any thoughts? :/


I was unaware that any of the mood stabilizer affected GABA until I came across this post. I don't know of any mood stabilizers that affect GABA at all. Also there is no edication that works strictly as a GABA reuptake inhibitor that know of.

Don't be so quick to jump the gun that GABAerigic drugs are going to be the most beneficial to you. I've been on benzos for over three years. During the first two years I spent enough tie on just about every SSRI in the book, looking for a longer solution so I could get off of benzos. All the SSRI's made me experience more anxiety and depression. I would talk to the doctor and they'd have me try s different SSRI.

Finally I found a doctor who actually listened to me and took note of the fact that almost all of close relatives suffer from bipolar. So I went on Lamictal, with the idea in mind that I might have bipolar II. What do you know, Lamictal has been great and it has no affinity whatsoever for gaba, it's method of action isn't really known but it started out as an anti-seizure med. My anxiety has actually been significantly reduced and I am taking fewer benzos. My depression is almost completely gone as well.

Something I've read in several sources and that my new doctor told me is that for bipolar patients, the increased serotonin from an SSRI can make the mania/hypomania feel much more like extreme anxiety to the patient. I think that th is what was going on with me. With most SSRI's I'd get very manic/depressive; staying up and going crazy without any sleep for two weeks then totally depressed, crashed and sleeping for two weeks.

The gaba system in the brain is fairly well understood but the mechanism by which many other drugs affect anxiety/depression is not so well understood. So I think that it is premature to say that gabaergic meds will be best for you.

Have you been on SSRI's and what as your experience like? With the mood swings have you considered that bipolar might be a possible diagnosis? I'm very surprised by how much lamictal has helped to improve anxiety because I didn't see that anxiety was part of the manic/depressive cycle for me. I was severely depressed at the time and all of the anti-depressants had made me more miserable so I figured I'd give lamictal a go to see if it lifted my depression.

I should also not that I was suffering from severe crippling anxiety. I spent a year totally agoraphobic, afraid to leave my room and every day was one long panic attack. I got on benzos which allowed me to live but I was trying to find something that would fix the root of the problem much more. All the SSRI's/SNRI's really messed me up and now I've found more anxiety relief from a drug that has no effect on gaba than any other drug I've been on.

just my two cents.


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## Darrenlogan56 (Jul 26, 2012)

istayhome said:


> I was unaware that any of the mood stabilizer affected GABA until I came across this post. I don't know of any mood stabilizers that affect GABA at all. Also there is no edication that works strictly as a GABA reuptake inhibitor that know of.
> 
> Don't be so quick to jump the gun that GABAerigic drugs are going to be the most beneficial to you. I've been on benzos for over three years. During the first two years I spent enough tie on just about every SSRI in the book, looking for a longer solution so I could get off of benzos. All the SSRI's made me experience more anxiety and depression. I would talk to the doctor and they'd have me try s different SSRI.
> 
> ...


"Valproic acid (VPA) is a chemical compound and an acid that has found clinical use as an anticonvulsant and *mood-stabilizing drug,* primarily in the treatment of epilepsy, bipolar disorder, and, less commonly, major depression."

"valproate semisodium is used as a *mood stabilizer *and also in the U.S. as an anticonvulsant."

"Valproate is believed to affect the function of the neurotransmitter *GABA* in the human brain, making it an alternative to lithium salts in treatment of bipolar disorder. Its mechanism of action includes enhanced neurotransmission of *GABA* (by *inhibiting GABA transaminase*, then *GABA* would increase in concentration)." -Wiki Quotes 

Surley you've read of some anti-epileptics being classed as Mood stabilizers and have effects on Gaba? you even quoted it a few comments above about Depakote which is this valproate semisodium gear!

I may sound like I'm jumping the guns but similarly to you, I also have tried almost all of the SSRI'S from Citalopram, escitalopram, Fluoxetine, Sertraline, then on to Effexor (but refused to continue it) then on to the Trycyclics. The SSRI'S did very little to improve my depression, I mainly just got side effects, however when I started trycyclics something just clicked, and my mood IN COMBINATION with the right therapy and life changes started slowly picking me back up on the horse again,

I have read up about lamictal and admit that it has intrigued me. I have thought before that it would do me good seen as my own self diagnosing matched almost all the diagnosis symptoms of a typical Bipolar II / Borderline personality disorder. However, finding most relief from Gaba acting drugs I've been researching for a lamictal type drug that works more on Gaba because I just naturally assumed that any gaba enhancement action of some sort would tone down my anxiety. I do seem to benefit from that Glutamate -reducing types of drug which is perhaps why i get most benifit from high doses of my Lyrica. I've been given so many diagnoses over a period of many years that I do not believe there is any real diagnosis. "what is normal?" that kind of thing. Y'know? I'm not someone who sits down and lets a doctor tell me I'm bipolar and was manic one time and then suffering from hypomania and this n that. I understand that the bipolar disorder is dramatized and blown out to be a disorder with people running around like lunatics and then wanting to kill themselves the next minute, in our society these days and get that theres Phase II and Phase I etc. I just don't believe that I am Bipolar, 
However I am prepared to 'go along' with a diagnosis next time I see my pdoc if it will give me a chance to try these meds like lamictal and depakote etc, to see if perhaps that was the problem and not actually Anxiety related.

I really don't want to have to start a medication that I have to get regularly checked/ tested for for blood levels etc, and sticking to these restricted diets. I hope I can also take my Adhd meds on the mood stabelizer/ anti siezures and get the benifit.

I am glad that you have found your relief from your illness!


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## TheoBobTing (Jul 8, 2010)

One thing that suggests that I don't have low GABA is the fact that alcohol affects me like it affects most people. Alcohol to some extent relies upon the presence of endogenous GABA to exert its anxiolytic effects. I'm no less susceptible to the effects of alcohol than the average guy.

Lorazepam and diazepam seem to be metabolized differently, so I'm not so sure it's a metabolism issue that accounts for why neither affected me in substantial doses.

Possibly it could be a GI tract type issue, or a benzodiazepine receptor issue. If it is the former, a sublingual benzo could be effective.


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## jim_morrison (Aug 17, 2008)

TheoBobTing said:


> This is feasible, and I'm wondering about trying to get a sublingual benzo prescribed. But aren't different Benzos metabolized in different ways? I've tried lorazepam and diazepam at substantial PRN doses and neither did anything, yet according to this chart, they are metabolized differently: http://www.pharmgkb.org/views/pathway/PA165111375.png
> 
> EDIT: I have Gilbert's syndrome, which is a common and quite tame syndrome. But could it affect drug metabolism?


Yes you're right, different benzos are metabolized in different ways, So I'm not 100% certain what's going on, it might be worth reading up on first-pass metabolism. Perhaps your gut isn't breaking the drugs down properly or something like that. I'm not sure about Gilbert's syndrome.


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## TheoBobTing (Jul 8, 2010)

On Depakote, alcohol doesn't seem to be as much fun as it used to be. I now just get 'bleh' drunk. I also had a weird dream about not wanting to go down a load of flights of stairs because I was frightened of falling. Overall, this stuff is Depascrote, or semisodium ball-ache


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## TheoBobTing (Jul 8, 2010)

"At the present time, the benzodiazepines are administered by both the oral and the parenteral route. The oral route of administration is the most common in therapeutic practice, *but sometimes it is not possible to achieve sufficiently high plasma concentrations to be effective, and some patients occasionally have an absorption malfunction.* Moreover, oral administration is precluded for patients with gastrointestinal intolerance, or those in preparation for anesthesia or who have had gastrointestinal surgery."

http://www.surechem.org/index.php?A...tab=desc&lang=EN&db_query=2:0:&markupType=all


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## rustybob (Nov 19, 2009)

istayhome said:


> Also there is no edication that works strictly as a GABA reuptake inhibitor that know of.


Tiagabine is a GABA reuptake inhibitor. It's available in Canada, not sure about the US. I don't think it's a popular drug. A quick read on Wikipedia says that even though it's supposed to be an anti-convulsant, it can cause seizures in people whom have never had seizures before.


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## basuraeuropea (Jul 25, 2012)

rustybob said:


> Tiagabine is a GABA reuptake inhibitor. It's available in Canada, not sure about the US. I don't think it's a popular drug. A quick read on Wikipedia says that even though it's supposed to be an anti-convulsant, it can cause seizures in people whom have never had seizures before.


it's available in the US as well and has proven to be efficacious in controlling anxiety-spectrum disorders by some studies, although not all. my doctor wanted to prescribe it to me once, but changed his mind due to the increased risk of seizure and me not having trialed all conventional treatment methods yet.


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## hupitup (Nov 30, 2012)

*Depakote helped me when a lot of other stuff did not*

I'm on it only 2 weeks now taking 250 mg 3 times a day. I've suffered from depression and anxiety all my adult life and have been misdiagnosed all that time up till now as far as I'm concerned. 
Recently a medical professional said I had many of the signs that lead her to believe I was bipolar. Anyway, I can't say enough about this drug and what it has done for me. I am able to have a positive thought again. It's been a while! I'm not the edge of panic at all like my anxiety always made me feel. I'm pretty relaxed as a matter of fact but able to get all my work done too.
Benzos, alcohol etc. , well, there just isn't enough of it to cure what I had. I went down those roads. They were freakin dead ends. 
You just need more and more all the time. 
By the way, it took no longer than 3 days to start seeing good effects unlike all the SSRIs that did nothing but cause me more stuff to deal with in the way of side effects, as I waited for the 30 days to feel great...I never did.
I am eating quite a bit and will have to change what I eat as well as burn more calories but I don't care. This drug has changed my life I hope it keeps it up!!
I wish the best for you all and encourage you to keep fighting and looking for a way out.
It's a nightmare no doubt but you gotta hang on to hope if nothing else!

Everyone should experience clinical depression and about a month straight of anxiety so they can see just what we deal with. They would be more empathetic for sure.


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## bazinga (Jun 9, 2010)

If depakote doesn't work for you maybe give lamotrigine (brand name: Lamictal) a try. Two friends of mine as well as I all take lamotrigine. Yes we're all bipolar and nuts. I don't experience mania, just wild mood swings, racing thoughts, and depression/irritability mostly. I shifted from feeling good to depressed every 1-2 months like clockwork no matter what meds I took until I was finally put on lamotrigine. Lamotrigine is a godsend for me.


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## ladysmurf (Jan 3, 2012)

I know this is an old post, but can anyone confirm if they have received any benefit from Depakote as far as anxiety goes?


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## rockyraccoon (Dec 13, 2010)

ladysmurf said:


> I know this is an old post, but can anyone confirm if they have received any benefit from Depakote as far as anxiety goes?


I took Depakote for a long time. I started off at around 250 mg and in the end my final dose was 2000 mg daily. It didn't help my anxiety at all. Mind you it didn't work for depression or irritability as well. I stopped taking it because, quite frankly, it wasn't doing anything. I did get a weird side effect on it in which I could not dream on it.


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