# Lithium, Depakote combined?



## EgoLost (Feb 5, 2006)

Hey,

My Doc just prescribed me Depakote in addition to my Lithium. That's 600mg of Lithium (relativily low), and 400mg of Depakote per day. I'm not feeling any improvement from the Lithium, but it's also not causing any side effects. They didn't test for my Lithium blood level but they tested for everything else you can possibly test for. So my Doc had to test me again!!!LOL, anyway I needed something to help with the Depression/Anxiety I still deal with. I can't take SSRI's, Buproprin, or the like since they just don't agree with me. I tried to get one of the TCA's but he didn't wanna try any of those so he gave me a script for Depakote. I know these are both mood stabalizers, and aren't generally scripted together. I did find a few cursory trials/research things that used the a combination of the two, but nothing relativily procedure or run of the mill for them. 

My question is has anyone else heard of this combination or actually been on it??

By the way if you haven't read my other posts I'm also on Seroquel 125mg a day.

:thanks


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## firedancer (Nov 14, 2003)

I have not heard of that particular combo, but anything is possible.

My pdoc just put me on Depakote too (250mg) and I am also on Lamictal (now 100mg). From my understanding, in my case, the Lamictal is for the BP depression end of the spectrum and the Depakote is for the hypomania. I am also taking Lyrica for my migraines (not working) but it has helped my anxiety.

I go back to my pdoc next week. And will have to have my blood checked then.

Let us know how you are doing. I'm curious about your combo.

_jen


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## EgoLost (Feb 5, 2006)

*cool*

I missread the prescription, it's actually 250mg twice a day, instead of 200mg, sorry. Like I said there have been a few cursory studies done on the combination. Also I haven't found any interactions between them that could be potentially toxic, only complications relative to the illness they are used to treat. Nothing new about that though.

I'll let you guys know how it works.

P.S. I have saw some studies related to the combination of Lamitcal and Depakote, or Lamictal and Lithium. So there may be some promise there for you!


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## firedancer (Nov 14, 2003)

I hope this combo works.

Have you checked out http://www.crazymeds.org ? There is ton of info there and they have a message board too. Also http://www.crazyboards.org (used to be the same thing and they split).


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## EgoLost (Feb 5, 2006)

Thanks firedancer,

I wasn't aware there was a "New" Crazymeds forum. I frequent the old one and The actual Crazymeds Info pages. 

I noticed someone replyed to one of your posts saying not to take Aspirin or Alkaseltzer(sp). This is very true, my Doc told me this and my prescribing info also noted it. Just a reminder.

For anyonoe else who is wondering, I did see someone mention on that same crazyforum post taking Depakote and Lithium together. It's not all "THAT" uncommon I think. Just not heard of much.


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## firedancer (Nov 14, 2003)

i read the PI sheet so i knew about the aspirin. i'm taking vicoprofen for my migraine pain, so i'm covered there too.


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## Caedmon (Dec 14, 2003)

Why the Depakote? Have you been cycling/manic?

Depakote + Lithium is a very common combo, especially if you want something that works fast. Also along with Seroquel - sounds okay to me. They _did_ test your Lithium blood level initially, right?


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## EgoLost (Feb 5, 2006)

I asked for something other than an SSRI for some persisting depression and anxiety. I think he's trying to hold me over till the Lithium and Seroquel kick in. As far as the Lithium blood testing; I supposedly had the test last month, but they tested everything BUT my Lithium level. Doctors mistake, so I had it done today. I'm still on only 300mg twice a day. I have no side effects or benefits from the lithium, so I figure I'm not at the theraputic dose yet, but I'll stay at the same dose till the test comes back.

I honestly wasn't aware this Lithium/Depakote combo was that commonplace. I've found very little research, etc on it. You don't have any links you could steer me toward do you Caedmon?

Also I see that I need to be blood tested for the Depakote too. :stu


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## Caedmon (Dec 14, 2003)

EgoLost said:


> I asked for something other than an SSRI for some persisting depression and anxiety. I think he's trying to hold me over till the Lithium and Seroquel kick in. As far as the Lithium blood testing; I supposedly had the test last month, but they tested everything BUT my Lithium level. Doctors mistake, so I had it done today. I'm still on only 300mg twice a day. I have no side effects or benefits from the lithium, so I figure I'm not at the theraputic dose yet, but I'll stay at the same dose till the test comes back.


Argh! :mum For all we know, Lithium could be effective _monotherapy _if it were only at an effective blood level! Well I assume you'll figure all this out when the labs come back.

Not sure that this combination is common, but I wouldn't think it *un*common. Lithium for depression and Depakote for mania or something like that. Is all I was thinking. Depakote does make sense for anxiety, although not really for depression.

Read everything on Dr. Phelps' page. Or straight to treatment. Read every link! I love this page.


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## firedancer (Nov 14, 2003)

That is a great link. I have spent alot of time on that site.

_jen


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## Caedmon (Dec 14, 2003)

Have you taken the Depakote yet Travis? How is it affecting you? How about you Jen?


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## firedancer (Nov 14, 2003)

or me, doc told me i could stop the seroquel. so i was hoping that it help with my insomnia (from mania) that i have had the past 2.5 weeks. nope. i'm still staying up all night. this is something that i will have to address next week at my next appt.

other than that, just some stomach discomfort.


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## EgoLost (Feb 5, 2006)

I started this morning. Depakote reminded me of Lithium in a way when I started using it. Slightly blurred vision, (not all the time, transient), dry taste, but unbelievably no stomach discomfort. It has made me tired, in a way. Not so much zonked out, but "i could take a nap," tired. As long as I'm busy I don't notice it much.

I think it's actually cooled the anxiety off a bit today, that's a good thing. But it has seemed to elavate the depression. This may be because of the fatigue it is causing. I just can't seem to kick this down in the dumps feeling, that I have for no reason.

Tommmorows another day, but looking optimistic!!!


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## firedancer (Nov 14, 2003)

you are taking it the morning? my pdoc told me to take it at night.


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## EgoLost (Feb 5, 2006)

Taking it twice a day at Breakfast and Dinner. Today was better, I wasn't as tired actually. It's not so bad really. I think it's helping a little. But not as much as Lithium did when I first started it.


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## firedancer (Nov 14, 2003)

i think that i am going to have to call my pdoc. i've been on it a week and have not sleep a single night. i usually make myself go to bed around 7am and i sleep for about 4 hours and them i'm up again. i've been told that this is not typical.

i don't know, but he will probably tell me to up the dosage.

_jen


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## Caedmon (Dec 14, 2003)

Are you still taking the same Seroquel along with the new Depakote Jen?

I'm having trouble sleeping too, I don't know if it's hypomania or what. Functioning on 2 hours despite not being tired is... surprisingly crappy. I took some Risperdal (2 mg) and that is helping a bit.


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## firedancer (Nov 14, 2003)

Pdoc told me to stop the Seroquel, but I taken it since I started Depa but didn't notice any tiredness. Funny because before the hypo, I could take 75mg a night and sleep like a baby. Before Depa, it got to the point where it didn't work when I was hypomanic and I've been like this for almost 4 weeks now. I'm up all night and it sucks. I'm not tired at all.

I'm going to call him tomorrow. Hopefully he can recommend something.


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## EgoLost (Feb 5, 2006)

Seroquel only makes me sleep if I'm already tired and exausted. In that state I'm out like a light. But if I'm well rested it won't do a thing. That's at 100-125mg. 

Along with Depakote the last few days it's cuased enough fatigue to do the trick at 100mg. That's a good thing I guess, but who wants to get that tired everyday to sleep? Ya know even deep, hard sleep feels taxing on the body, in a tiring sense!

But I'm able to sleep for at least 6 hours. I can not really complain on the sleep side.

Firedancer,

You haven't slept since you started the depakote? I'd reconsider its benefits before I dropped the old scripts, i.e. Seroquel.


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## firedancer (Nov 14, 2003)

I called my pdoc today and he's out of the office until Mon, which is when my appt is.

I'm really considering taking the Seroquel anyway. If I have to take more than the usual 75mg, then I will. 

The problem is that I am wired at night. And when I wake up from the 3-4 hours of sleep, I'm wired again (unless I have a migraine, which I still am).

Oh, sorry for the thread hijack.


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## EgoLost (Feb 5, 2006)

It's ok Firedancer. No problem!!


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## Caedmon (Dec 14, 2003)

firedancer said:


> I'm really considering taking the Seroquel anyway. If I have to take more than the usual 75mg, then I will.


Is it contraindicated? I would check one of those online med checkers, or even better, call up a pharmacist. If it's not a problem, I say take the Seroquel (at least until you can see your psych on Mon.)

Good luck... to us all. :lol


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## EgoLost (Feb 5, 2006)

*UPDATE!!!*

Ok guys,

I went to the Pdoc today. I asked to drop the Depakote. The fatigue, tiredness, and irratability proved to much. My girlfriend has been telling me I look like a zombie. That rung a bell for me! So I went to the doc and asked to switch to an antidepressant, since I was asking for that the first time!! I asked to try Effexor along with Provigil. Got the scripts with no problem, I can see I have great doctors!! They hardly ask any questions except for safety related ones, they're very understanding.

So I'll try this along with my Lithium and Seroquel for two weeks and go back for a check up. I took my first doses around 11am and haven't noticed any real change. Some minor stomach discomfort and what feels like indigestion.

Definatly to early to tell, but the fading Depakote will not be missed. It feels nice to come back to life again. I hadn't noticed how much I'd changed in only a week!!!

:banana


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## firedancer (Nov 14, 2003)

Just so that you will know, one of the side effects of Effexor is heartburn. It was one of the side effects that made me want to stop taking it the most.

I am the opposite, I'm hoping that my doc will increase my Depakote so that I will finally sleep.

Good luck with your med changes!


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## Caedmon (Dec 14, 2003)

Are you starting Effexor and Provigil at the same time or sequentially? I always like to try medications in steps unless I already know how it will affect me. That way I can (relatively) isolate its effects. Not that it's perfect, but, you know. 

I see the doc in about ten days so I'm trying to decide what would be the best thing to take for me. Actually (in line with the original thread topic,) I'm really thinking about Lithium right now. 

I am about 80% sure that the Effexor I am on causes tinnitus, so I want to stop it and take something else. Something with antidepressant/antimanic properties would be wonderful. Hence the Lithium. Lamictal too, I just worry about it taking too long (I'd have to be on Risperdal for another 2 months). Hrm, I have no idea I guess. :lol


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## firedancer (Nov 14, 2003)

My appt is tomorrow (or actually today - I'm up as usual). I think that I may take a Xanax and see if that will help. Probably not, but at this point I will try anything. If I could drink, I think that I would. But I know better being on all these meds.

Chris - I agree that Lamictal takes a while. I've been on it since Sept and when I finally got to 200mg, I felt better after a month. That is a long time, but it is so worth it now. I would seriously fight with my pdoc if he tried to take me off of it. He asked me last time how I felt it was working. He better not be thinking Lithium. 

Travis - Good to see you over at CrazyBoards. I really enjoyed reading your threads. Very informative.

_jen


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## EgoLost (Feb 5, 2006)

Hey,

Sorry for the late reply, long work week. I do twelve hour shifts!!!

Anyway, Caedmon, I took both the first day in hopes it would null the Depakote, and it did, thankfully. The second day it kinda wired me out so I stopped the Provigil. I'll probably wait a few weeks to add the Provigil back. Currently there are no major side effects from the Effexor. Some mild heartburn as Firedancer mentioned and a bit of stomach discomfort. Otherwise all is good, and it seems to be helping a little.

I have also recently determined 100mg of Seroquel is my maximum dose. I've tried 125mg on a few occasions to help with sleep. At 125mg I get really loopy, unsteady and get a weird hot, shivery sensation throughout my body. It's really uncomfortable and a bit scary. I'm not sure what it is, but I know I'm fine at 100mg. I wonder if anyone else has experianced this?!

As you guys know Lithium really helped at first while I was adjusting to it. I would certainly recommend it, if something of that nature is needed. The key as you know is finding that right dose, which I'm still trying to do!

Firedancer, thanks for the link to the Crazyboards forum, I had no idea it existed, lol. There's a lot of great stuff over there. I think Caedmon can take the prize for most informative.


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## firedancer (Nov 14, 2003)

My doc doubled my Depa to 500mg taken at night and told me I could take the Seroquel as needed (I'm trying not to take it unless I absolutely have to) at 75mg. I haven't tried more than that because it works, so I haven't had any of those effects Travis. 

So far on day 2, went to bed last night at 3:30 so that was an improvement. And I'm yawning now (3:00am).

Now if I can get off of this Lyrica I would be happy.


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## EgoLost (Feb 5, 2006)

From my brief experiance I would really believe 500mg would do the trick for you. Are you very active Firedancer? I've found when I go through periods of insomnia and restlesness that being active, or exercize seems to help. I try to stay on the go all day, and it seems to help tire me out. Then with the addition of Seroquel or some other sedating med it's pretty easy to sleep. I'm just thinking there may be some other underlying reason you can't establish a healthy sleep pattern.


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## Jackbirdie (Nov 30, 2012)

I was just browsing through this thread and was stopped in my tracks by Travis' comment about the weird Seroquel side effect- hot shivery weirdness throughout my whole body? Yup! Hate it so much I stopped taking S altogether.mmy doctor didn't really want me on it long term anyway. What's doubly strange is when I was super manic (my brother was dying) I was on 800 per day. Never felt a side effect. Now I can't take even 100 without feeling it. So I'm off now. Take lithium fairly successfully but have bad tremors and still hypomanic, mixed episodes, or something. Originally got on this site and thread looking for feedback on lithium plus depakote. So, thanks everybody !


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