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Anti-convulsants And Migraine Prophylaxis


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#1 medi

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Posted 05 November 2008 - 04:04 PM

I have a very severe migraine condition, frequent, debilitating migraines. It seems that Depakote and Topamax are often administered for migraine prevention. I am one of those rare people who got suicidal (totally obsessed) on Topamax. Depakote seems to be favored by very few because of its side effects. I need help with migraine as I am titrating down my Inderal, planning to cut it out. Of course, I'd welcome an anti-depressant effect too. My lethargy is already terrible. I don't get out of bed. As crazy as it sounds, I am reconsidering Topamax, with Lithium on board this time, hoping I kill two birds with one stone, migraine and lethargy.
Anyone treating both mental disorder and migraine?
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<p>Dx Axis 1: BD II. Had been diagnosed with MDD. Am sometimes also diagnosed with PTSD.Has undergone ECT in 2008.Current Meds: Lithium 600 mg, Synthroid 75 mcg, Inderal 40 mgs, Ativan 2 mg or more, as needed, Zolpidem.Have had experience with: Tricyclics (useless back then), Paxil, Celexa & Lexapro ( the three caused jitteriness&/or mixed states), Wellbutrin (also jitteriness, more severe), MAOI-B (Emsam patch)(hypomania, fun, but no way I could sit at my desk and think), Neurontin (innocuous), Depakote (too much weight gain, hair loss, sleepiness, lack of energy, and no noticeable benefit), Topamax (I'll only cite the suicidality obsession as of 75 mgs....), Lamictal (no benefit), Zyprexa (heart palpitations and shortness of breath at only 2.5 mgs), Abilify 2 mgs (serious GI pain), Calcium Channel Blockers (weak --- verrrry).



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#2 Stacia

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Posted 05 November 2008 - 04:36 PM

I get migraines. Depakote has done wonders. I've only had one migraine in over nine months, and the one I did was during some med changes and slightly scrambled brains. The side effects, however, are enough for me to start trialing Tegretol. Weight gain is the biggest one. Depokote for me came with an inhuman appetite (I mean truly unnatural) which subsided after a few months. Afterwards, I think my matabolism just slowed or something because I continued to gain for a while and the weight has since been impossible to get off. All that said, Depakote does not have side effects for everybody. Some people do not gain weight. As for AD effect, I'm not sure Depakote is the answer... but who knows. My pdoc has had patients who did get a little AD effect from it. Others find it a very depressing med. It's been neutral for me affect-wise.

Tegretol does not have the same efficacy with migraines by reputation, but I am hoping that it will and also control my rapid cycling. We'll see. I may be expecting too much. But I will not know until I try. Same goes for you. Based on your Topamax experience, I'd try Depaote. Since it's for migraine and not bipolar, you should be able to bail on it pretty easily if it's not working out.
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#3 Mrs. Singer

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Posted 05 November 2008 - 05:52 PM

I'm on Topamax for migraines now and my doc said that if it doesn't work the next step would probably be Depakote. He said he would put me on Depakote CR because that could help ease a lot of the side effects.

But I can tell you from experience that my doctor is not exactly truthful about drug info, so I don't know.
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#4 junky69

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Posted 06 November 2008 - 06:01 AM

Keppra. Started it in 6+ yrs & have not yet needed to use my trusty Imitrex.
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#5 newton

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Posted 12 November 2008 - 05:48 PM

Just to add my own experience: Topamax left me manic. Depakote has done absolute wonders for my mood and for my migraines. The only migraine I have had since starting the Depakote was a direct result of lowering my dose. I have not gained a single pound. I *did* lose a ton of hair, but it all grew back within a couple of months.
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#6 medi

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Posted 12 November 2008 - 06:35 PM

Just to add my own experience: Topamax left me manic. Depakote has done absolute wonders for my mood and for my migraines. The only migraine I have had since starting the Depakote was a direct result of lowering my dose. I have not gained a single pound. I *did* lose a ton of hair, but it all grew back within a couple of months.

This is very encouraging Newton. You are actually on something that works for both migraine and mood. When you say the hair grew back, do you mean after you lowered your dose? Cause you're still on it, right? And what about fatigue, sleepiness? What happened on that front?
I have another, more important question, could you distinguish the effectiveness of Depakote on either mania/hypomania or depression?
And, finally, just what is your dose?
Thanks.
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<p>Dx Axis 1: BD II. Had been diagnosed with MDD. Am sometimes also diagnosed with PTSD.Has undergone ECT in 2008.Current Meds: Lithium 600 mg, Synthroid 75 mcg, Inderal 40 mgs, Ativan 2 mg or more, as needed, Zolpidem.Have had experience with: Tricyclics (useless back then), Paxil, Celexa & Lexapro ( the three caused jitteriness&/or mixed states), Wellbutrin (also jitteriness, more severe), MAOI-B (Emsam patch)(hypomania, fun, but no way I could sit at my desk and think), Neurontin (innocuous), Depakote (too much weight gain, hair loss, sleepiness, lack of energy, and no noticeable benefit), Topamax (I'll only cite the suicidality obsession as of 75 mgs....), Lamictal (no benefit), Zyprexa (heart palpitations and shortness of breath at only 2.5 mgs), Abilify 2 mgs (serious GI pain), Calcium Channel Blockers (weak --- verrrry).

#7 newton

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Posted 12 November 2008 - 08:03 PM

This is very encouraging Newton. You are actually on something that works for both migraine and mood. When you say the hair grew back, do you mean after you lowered your dose? Cause you're still on it, right? And what about fatigue, sleepiness? What happened on that front?
I have another, more important question, could you distinguish the effectiveness of Depakote on either mania/hypomania or depression?
And, finally, just what is your dose?
Thanks.


Depakote has indeed seemed to be something of a miracle for me. Part of me wants to herald it as a miracle drug, and think that it does not deserve its terrible reputation. But I also know that I have some pretty weird reactions to meds in general that sort of exclude considering me as a good test case. (And, of course, we all know how useful a sample size of one is.) I don't mean to be pessimistic- I actually think Depakote is definitely worth a shot for anyone experiencing anything like BP and migraines- but I also don't want to give you too much false hope. So, here's what I can tell you:

First, your specific questions:
I am on 750mg of Depakote. This is, quantitatively speaking, an extremely low dose. But, because I just happen to be someone who metabolizes it very slowly, that dosage leaves me in the therapeutic range at about 100.

The regrowth of hair seemed independent of dose adjustment, but I could be wrong about this. They lowered the dose from the starting dose of 1000 mg about a week and a half after I started taking it (when my blood tests revealed I was too high at 152). This was before I noticed any hair loss at all (though, of course, it could have been delayed). I noticed the hair loss maybe three weeks later. And let me tell you, for a couple of weeks I thought I was going to be completely bald, with all the hair I lost! But it only lasted for that couple of weeks. And a month or two later I noticed a bunch of new growth. And now my hair is completely back to normal.
I've had several doctors tell me that Depakote just sort of shocks the system, causing the hair-loss, and that it usually is dose-related. They also told me that the weight gain usually appears way before the hair loss. (Since I didn't gain any weight, I didn't have that indication.) So you might end up having to lower the dosage to prevent weight gain well before you need to worry about hair loss. And actually I think, if migraines are your principle concern, a much lower dose, with much lower risk of side effects, may work.

As for moods. I think this drug just about saved my life. I was a complete mess before I started taking it. The Topamax had me in a mixed state so bad I couldn't decide if I was such bad person that I was morally required to stay up all night cleaning every molecule of my apartment or kill myself. The Depakote turned this all around for me. And it stopped most of the problems I had prior to the Topamax- the more normal BP stuff. The agitation and irritability were almost completely gone. My thoughts stopped racing, and the automatic and invasive negative thoughts subsided a great deal. And- thank heaven!- I could think clearly again!! In particular, it helped me with depression. I was able to get out of bed and off the couch again. I would wake up and actually want to get out of bed, and I could do things all day long without winding up in a semi-catatonic state. It had been about three years since I had experienced this.

One more thing I want to say. The first week I was on the Depakote, I experienced tremendous agitation, anxiety, and rage from hell. It was an extremely painful week. However, from what I gather, this never happens. In fact, my doctor completely dismissed this as an effect of the Depakote. (He was definitely wrong, but it's probably not worth getting into.) I don't want to discourage you, I just wanted to warn you, since it almost prevented me from giving the med a fair shot.

Anyway, here's my take on it: Depakote is defintely worth a shot. It might not work out, sure, for all the reasons the doctors will tell you. But it if it does work out, it reeeaaally works. Seriously, for the migraines alone, its worth a shot. (My migraines were the truly incapacitating, three-days-locked-in-a- lightless-room-but-kill-me-anyway, kind.)

Let me know if there is anything else you want to know. (And sorry to be so long-winded! I just remember wishing I had had someone to go through this with me!)
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#8 medi

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Posted 13 November 2008 - 05:15 AM

I get migraines. Depakote has done wonders. I've only had one migraine in over nine months, and the one I did was during some med changes and slightly scrambled brains. The side effects, however, are enough for me to start trialing Tegretol. Weight gain is the biggest one. Depokote for me came with an inhuman appetite (I mean truly unnatural) which subsided after a few months. Afterwards, I think my matabolism just slowed or something because I continued to gain for a while and the weight has since been impossible to get off. All that said, Depakote does not have side effects for everybody. Some people do not gain weight. As for AD effect, I'm not sure Depakote is the answer... but who knows. My pdoc has had patients who did get a little AD effect from it. Others find it a very depressing med. It's been neutral for me affect-wise.

Tegretol does not have the same efficacy with migraines by reputation, but I am hoping that it will and also control my rapid cycling. We'll see. I may be expecting too much. But I will not know until I try. Same goes for you. Based on your Topamax experience, I'd try Depaote. Since it's for migraine and not bipolar, you should be able to bail on it pretty easily if it's not working out.

Hey Stacia -- Aside from appetite increase, what other side effects? In particular, how was hair loss and energy level for you?
I am seriously impaired by the migraines. The depression seem to be lifting a tiny bit, perhaps that small intro dose of Abilify as of a few days ago. But I am failing even at the part-time job I took because of my migraines. I'm going to have to move from my one-bedroom into a studio in the boonies if this continues.
I had taken Depakote in the past, by the way everyone. It's just too far back in the past for me to remember specifics. I remember sleeping a lot, losing hair a lot, and gaining weight a lot. But I'm running out of options.
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<p>Dx Axis 1: BD II. Had been diagnosed with MDD. Am sometimes also diagnosed with PTSD.Has undergone ECT in 2008.Current Meds: Lithium 600 mg, Synthroid 75 mcg, Inderal 40 mgs, Ativan 2 mg or more, as needed, Zolpidem.Have had experience with: Tricyclics (useless back then), Paxil, Celexa & Lexapro ( the three caused jitteriness&/or mixed states), Wellbutrin (also jitteriness, more severe), MAOI-B (Emsam patch)(hypomania, fun, but no way I could sit at my desk and think), Neurontin (innocuous), Depakote (too much weight gain, hair loss, sleepiness, lack of energy, and no noticeable benefit), Topamax (I'll only cite the suicidality obsession as of 75 mgs....), Lamictal (no benefit), Zyprexa (heart palpitations and shortness of breath at only 2.5 mgs), Abilify 2 mgs (serious GI pain), Calcium Channel Blockers (weak --- verrrry).

#9 medi

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Posted 13 November 2008 - 05:32 AM

This is very encouraging Newton. You are actually on something that works for both migraine and mood. When you say the hair grew back, do you mean after you lowered your dose? Cause you're still on it, right? And what about fatigue, sleepiness? What happened on that front?
I have another, more important question, could you distinguish the effectiveness of Depakote on either mania/hypomania or depression?
And, finally, just what is your dose?
Thanks.


Depakote has indeed seemed to be something of a miracle for me. Part of me wants to herald it as a miracle drug, and think that it does not deserve its terrible reputation. But I also know that I have some pretty weird reactions to meds in general that sort of exclude considering me as a good test case. (And, of course, we all know how useful a sample size of one is.) I don't mean to be pessimistic- I actually think Depakote is definitely worth a shot for anyone experiencing anything like BP and migraines- but I also don't want to give you too much false hope. So, here's what I can tell you:

First, your specific questions:
I am on 750mg of Depakote. This is, quantitatively speaking, an extremely low dose. But, because I just happen to be someone who metabolizes it very slowly, that dosage leaves me in the therapeutic range at about 100.

The regrowth of hair seemed independent of dose adjustment, but I could be wrong about this. They lowered the dose from the starting dose of 1000 mg about a week and a half after I started taking it (when my blood tests revealed I was too high at 152). This was before I noticed any hair loss at all (though, of course, it could have been delayed). I noticed the hair loss maybe three weeks later. And let me tell you, for a couple of weeks I thought I was going to be completely bald, with all the hair I lost! But it only lasted for that couple of weeks. And a month or two later I noticed a bunch of new growth. And now my hair is completely back to normal.
I've had several doctors tell me that Depakote just sort of shocks the system, causing the hair-loss, and that it usually is dose-related. They also told me that the weight gain usually appears way before the hair loss. (Since I didn't gain any weight, I didn't have that indication.) So you might end up having to lower the dosage to prevent weight gain well before you need to worry about hair loss. And actually I think, if migraines are your principle concern, a much lower dose, with much lower risk of side effects, may work.

As for moods. I think this drug just about saved my life. I was a complete mess before I started taking it. The Topamax had me in a mixed state so bad I couldn't decide if I was such bad person that I was morally required to stay up all night cleaning every molecule of my apartment or kill myself. The Depakote turned this all around for me. And it stopped most of the problems I had prior to the Topamax- the more normal BP stuff. The agitation and irritability were almost completely gone. My thoughts stopped racing, and the automatic and invasive negative thoughts subsided a great deal. And- thank heaven!- I could think clearly again!! In particular, it helped me with depression. I was able to get out of bed and off the couch again. I would wake up and actually want to get out of bed, and I could do things all day long without winding up in a semi-catatonic state. It had been about three years since I had experienced this.

One more thing I want to say. The first week I was on the Depakote, I experienced tremendous agitation, anxiety, and rage from hell. It was an extremely painful week. However, from what I gather, this never happens. In fact, my doctor completely dismissed this as an effect of the Depakote. (He was definitely wrong, but it's probably not worth getting into.) I don't want to discourage you, I just wanted to warn you, since it almost prevented me from giving the med a fair shot.

Anyway, here's my take on it: Depakote is defintely worth a shot. It might not work out, sure, for all the reasons the doctors will tell you. But it if it does work out, it reeeaaally works. Seriously, for the migraines alone, its worth a shot. (My migraines were the truly incapacitating, three-days-locked-in-a- lightless-room-but-kill-me-anyway, kind.)

Let me know if there is anything else you want to know. (And sorry to be so long-winded! I just remember wishing I had had someone to go through this with me!)

Hey Newton, thanks, this was very helpful. But... yes, I still have questions! I gathered that it's been great for your mood and your depression. Wow! Hallelujah! I hope I'll have those results.
How long have you been on your 750 mgs?
At this point, it is my neuro and I who talked of Depakote, but of course we'd get the pDoc in on this once I feel close to a decision. My migraines have been terrible because barometric pressure is a sure trigger of the worst migraines for me, and we're having a lot of rainy days and sharp changes in barometric pressure. I keep drinking water.... in vain. The neuro suggested starting at only 250 mgs of Depakote. I am also someone super sensitive to medicines' good and bad effects.
I am a bit concerned about Depakote making me depressed since it seems that it targets and works better on mania, but that is not a major concern. I could add an AD. I am mostly concerned about energy, about hair loss, and about weight gain. I have already lost so much hair, I have bald spots. This from practically anything, Lithium, Lamictal Topamax. The weight gain scares me less if Depakote does nor really slow me down and make me sleepy. Last time I took it (years ago so I don't remember everything), I had very little energy and I would be so sleepy that I just could get nothing done, let alone get to the gym.
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<p>Dx Axis 1: BD II. Had been diagnosed with MDD. Am sometimes also diagnosed with PTSD.Has undergone ECT in 2008.Current Meds: Lithium 600 mg, Synthroid 75 mcg, Inderal 40 mgs, Ativan 2 mg or more, as needed, Zolpidem.Have had experience with: Tricyclics (useless back then), Paxil, Celexa & Lexapro ( the three caused jitteriness&/or mixed states), Wellbutrin (also jitteriness, more severe), MAOI-B (Emsam patch)(hypomania, fun, but no way I could sit at my desk and think), Neurontin (innocuous), Depakote (too much weight gain, hair loss, sleepiness, lack of energy, and no noticeable benefit), Topamax (I'll only cite the suicidality obsession as of 75 mgs....), Lamictal (no benefit), Zyprexa (heart palpitations and shortness of breath at only 2.5 mgs), Abilify 2 mgs (serious GI pain), Calcium Channel Blockers (weak --- verrrry).

#10 newton

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Posted 13 November 2008 - 08:12 AM

Hey Newton, thanks, this was very helpful. But... yes, I still have questions! I gathered that it's been great for your mood and your depression. Wow! Hallelujah! I hope I'll have those results.
How long have you been on your 750 mgs?
At this point, it is my neuro and I who talked of Depakote, but of course we'd get the pDoc in on this once I feel close to a decision. My migraines have been terrible because barometric pressure is a sure trigger of the worst migraines for me, and we're having a lot of rainy days and sharp changes in barometric pressure. I keep drinking water.... in vain. The neuro suggested starting at only 250 mgs of Depakote. I am also someone super sensitive to medicines' good and bad effects.
I am a bit concerned about Depakote making me depressed since it seems that it targets and works better on mania, but that is not a major concern. I could add an AD. I am mostly concerned about energy, about hair loss, and about weight gain. I have already lost so much hair, I have bald spots. This from practically anything, Lithium, Lamictal Topamax. The weight gain scares me less if Depakote does nor really slow me down and make me sleepy. Last time I took it (years ago so I don't remember everything), I had very little energy and I would be so sleepy that I just could get nothing done, let alone get to the gym.
[/quote]

From what I have gathered, starting at 250 mg is so very low- even for someone who ends up being as sensitive to this med as I am- that it is extremely unlikely you would experience the side effects you are worried about. Again, the Depakote did not seem to leave me lethargic at all- in fact it perked me right up to the point that I had as much energy as a normal person for once. (Of course, this may have been because my lack of energy was due to my BP, and so, once the Dep stablized me, I had energy again.) I have not experienced a lick of depression due to the Depakote. I *did* get quite sleepy on it, but this itself was something of a gift, since I had terrible insomnia at the time as well. I take the ER version, and I take it all at night. I'm asleep without problems about an hour later, and I wake up feeling refreshed with no hangover at all. (And I think the most pronounced sleepiness went away over time.) So it actually works out beautifully.

You probably don't remember what dosage you tried last time, right? What about whether it was the regular version or the ER version? The extended release version seems to take care of a lot of the side effects people experience with the regular version.

The hair loss thing was a big fat bummer, no doubt about it. I was so happy to get some relief after struggling so long that I managed to shake it off, but it was scary and upsetting. It really did all grow back, no problem. Seriously, it grew back just as it was before, absolutely no problem. Do keep in mind though, going by the numbers, it should be the least of your concerns. Most people notice a huge appetite increase before they will begin to lose hair. So, if you adjust your dosage to prevent that, you can be pretty sure that you won't have to worry about the hair loss. If you start at 250 mg, I don't really think you need to worry about any of these side effects.

Another thing to add about the migraines- not only does the Depakote work, it works *fast*. The day after I started taking it, I realized I had had an aura the day before and that it was gone. (One of the first indications I get before I get a migraine, and get before the other stuff like seeing spots, is this sort of weird and distinctive confusion. It's pretty hard to describe phenomenologically, and- fun for me- it makes it difficult to recognize that I am in fact getting a migraine.) This never happens for me- an aura always leads to a migraine. I've been on this dosage for about six months and I haven't had a single migraine. (I used to get approximately one migraine a month.)

So, I would suggest just easing into the Depakote. Give the 250 mg a try at first. It probably won't do much of anything for your mood, but also probably won't cause any side effects either. (Just make sure it is the ER version). And, once you get your most important problem taken care of- the migraines- that will give you some breathing room, and may help make the Depakote a little less scary. Then you can consider whether it is worth trying to up the dose to take care of the mood issues, or whether you'd prefer to go a different route. But definitely make stopping your migraines a priority above all else- and that includes (non-damaging) side-effects. It's just too difficult to think clearly with that kind of pain lurking around every corner. Release from that pain puts you in a position to see things in their proper perspective.

-Newton
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#11 medi

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Posted 13 November 2008 - 08:27 AM

It's interesting. Clearly, the way you write reflects your familiarity with this awful condition.

Last time I took Depakote, I don't think the ER version was out. It must have been 10 years ago, so, by the same token, I don't remember what dose I was on. I know it works fast, so did the dreadful Topamax.

I have to say, I am still worried about low energy and weight gain and hair loss even at 250 mgs. They marked me, so they must have been bad last time I took Depakote. I don't think I'm vain, but the way the psychiatric drugs affected my figure and hair and skin has been depressing.

I may just not have a choice though. I am not able to even hold down a part-time job with my migraine.
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<p>Dx Axis 1: BD II. Had been diagnosed with MDD. Am sometimes also diagnosed with PTSD.Has undergone ECT in 2008.Current Meds: Lithium 600 mg, Synthroid 75 mcg, Inderal 40 mgs, Ativan 2 mg or more, as needed, Zolpidem.Have had experience with: Tricyclics (useless back then), Paxil, Celexa & Lexapro ( the three caused jitteriness&/or mixed states), Wellbutrin (also jitteriness, more severe), MAOI-B (Emsam patch)(hypomania, fun, but no way I could sit at my desk and think), Neurontin (innocuous), Depakote (too much weight gain, hair loss, sleepiness, lack of energy, and no noticeable benefit), Topamax (I'll only cite the suicidality obsession as of 75 mgs....), Lamictal (no benefit), Zyprexa (heart palpitations and shortness of breath at only 2.5 mgs), Abilify 2 mgs (serious GI pain), Calcium Channel Blockers (weak --- verrrry).

#12 Stacia

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Posted 13 November 2008 - 09:17 AM

Hey Stacia -- Aside from appetite increase, what other side effects? In particular, how was hair loss and energy level for you?
I am seriously impaired by the migraines. The depression seem to be lifting a tiny bit, perhaps that small intro dose of Abilify as of a few days ago. But I am failing even at the part-time job I took because of my migraines. I'm going to have to move from my one-bedroom into a studio in the boonies if this continues.
I had taken Depakote in the past, by the way everyone. It's just too far back in the past for me to remember specifics. I remember sleeping a lot, losing hair a lot, and gaining weight a lot. But I'm running out of options.

The two other side effects I had/have are hair loss and smell. The hair loss was not as dramatic as Newtonian. It started about a month (?) after starting Dep. (I started at 500mg, went to 750mg a couple week later, and then to 1000mg a few weeks after that. My serum level (?) is relatively low.) The hair loss went on at a steady rate for four to five months. I have a.lot of hair but it ended up noticeably thin, at least to me. Then it stopped and new hair started growing in. The new hair is a bit frizzed, but I'm hoping that will change with time. If this is an issue for you, look into rogaine. I hear that it works well. The other big side effect is that Dep makes me smell. I hate it. At first it was strong enough for my coworker to comment that she knew I'd shown up for work because she could smell my perfume. I almost burst out laughing since my choice in perfumes would not be so bad! and I wanted to cry. This has diminished greatly with time, but it's still on my clothes at the end of the day. I'm not sure which I hate more, this or the weight that won't go away. I should point out that smelling like the med is I think a fairly uncommon side effect.

I don't feel sedating from Dep, but I'm on a sedating cocktail and it doesn't make me tired. I'm probably not the best reference. I can say that taking it at night and giving it some weeks before you make up your mind would be very smart. As for it acting like an antidepressant, some find it to be a reasonable strong one. Others find it depressing. I don't feel it either way. YMMV.

Personally, I'd give it a month or two trial. It may have a little cognitive impairment at first, but that goes away fast. I also would be surprised if you experienced that at 250mg. Your migraines sound debilitating and this may be your solution. The side effects experienced by others shouldn't sway your decision. I've met a couple people who have none.

PS - As for mood stabilization... Depakote greatly slowed the rapid cycling that none of other meds could touch. It can be a great BP med.

Edited by Stacia, 13 November 2008 - 09:19 AM.

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#13 Anna

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Posted 13 November 2008 - 10:45 AM

Just to chime in, I am another happy depakote user. Its efficacy beats out the side effects for me, although I'm not going to lie and say the side effects aren't annoying. They are.

Using the ER version makes a difference, for sure.

Anna
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#14 medi

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Posted 13 November 2008 - 01:49 PM

Just to chime in, I am another happy depakote user. Its efficacy beats out the side effects for me, although I'm not going to lie and say the side effects aren't annoying. They are.

Using the ER version makes a difference, for sure.

Anna

Thx, Anna. Same side effects for you too? Weight gain and hair loss? How's your energy level? If you take it for migraine prophylaxis, what is your dosage, please?
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<p>Dx Axis 1: BD II. Had been diagnosed with MDD. Am sometimes also diagnosed with PTSD.Has undergone ECT in 2008.Current Meds: Lithium 600 mg, Synthroid 75 mcg, Inderal 40 mgs, Ativan 2 mg or more, as needed, Zolpidem.Have had experience with: Tricyclics (useless back then), Paxil, Celexa & Lexapro ( the three caused jitteriness&/or mixed states), Wellbutrin (also jitteriness, more severe), MAOI-B (Emsam patch)(hypomania, fun, but no way I could sit at my desk and think), Neurontin (innocuous), Depakote (too much weight gain, hair loss, sleepiness, lack of energy, and no noticeable benefit), Topamax (I'll only cite the suicidality obsession as of 75 mgs....), Lamictal (no benefit), Zyprexa (heart palpitations and shortness of breath at only 2.5 mgs), Abilify 2 mgs (serious GI pain), Calcium Channel Blockers (weak --- verrrry).

#15 medi

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Posted 13 November 2008 - 01:58 PM

Hey Stacia -- Aside from appetite increase, what other side effects? In particular, how was hair loss and energy level for you?
I am seriously impaired by the migraines. The depression seem to be lifting a tiny bit, perhaps that small intro dose of Abilify as of a few days ago. But I am failing even at the part-time job I took because of my migraines. I'm going to have to move from my one-bedroom into a studio in the boonies if this continues.
I had taken Depakote in the past, by the way everyone. It's just too far back in the past for me to remember specifics. I remember sleeping a lot, losing hair a lot, and gaining weight a lot. But I'm running out of options.

The two other side effects I had/have are hair loss and smell. The hair loss was not as dramatic as Newtonian. It started about a month (?) after starting Dep. (I started at 500mg, went to 750mg a couple week later, and then to 1000mg a few weeks after that. My serum level (?) is relatively low.) The hair loss went on at a steady rate for four to five months. I have a.lot of hair but it ended up noticeably thin, at least to me. Then it stopped and new hair started growing in. The new hair is a bit frizzed, but I'm hoping that will change with time. If this is an issue for you, look into rogaine. I hear that it works well. The other big side effect is that Dep makes me smell. I hate it. At first it was strong enough for my coworker to comment that she knew I'd shown up for work because she could smell my perfume. I almost burst out laughing since my choice in perfumes would not be so bad! and I wanted to cry. This has diminished greatly with time, but it's still on my clothes at the end of the day. I'm not sure which I hate more, this or the weight that won't go away. I should point out that smelling like the med is I think a fairly uncommon side effect.

I don't feel sedating from Dep, but I'm on a sedating cocktail and it doesn't make me tired. I'm probably not the best reference. I can say that taking it at night and giving it some weeks before you make up your mind would be very smart. As for it acting like an antidepressant, some find it to be a reasonable strong one. Others find it depressing. I don't feel it either way. YMMV.

Personally, I'd give it a month or two trial. It may have a little cognitive impairment at first, but that goes away fast. I also would be surprised if you experienced that at 250mg. Your migraines sound debilitating and this may be your solution. The side effects experienced by others shouldn't sway your decision. I've met a couple people who have none.

PS - As for mood stabilization... Depakote greatly slowed the rapid cycling that none of other meds could touch. It can be a great BP med.

If it does not make you sleepy or rob you of energy, have you tried working out regularly? Do you gain weight despite working out?
I never heard of the smell effect, but unless your colleague was being saracastic (and very mean), it does not sound like a "bad" smell.
As for Rogaine, I have indeed heard that it is effective. My issue with it (aside from cost) is the fact that you can never break the routine. With migraine, there are so many days where brushing my teeth is a feat. But, then again, I'd not have to worry about not being able to stick to a routine if the Depakote is working. Also, I imagine that the cognitive impairment cannot be worse than either what Lamictal or what Topamax did to me. I just hope there would be no depressing effect. But none of you here who responded had it.
Finally, I'd hope I'd know within two weeks! I now have had two days in a row of a horrible migraine...
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<p>Dx Axis 1: BD II. Had been diagnosed with MDD. Am sometimes also diagnosed with PTSD.Has undergone ECT in 2008.Current Meds: Lithium 600 mg, Synthroid 75 mcg, Inderal 40 mgs, Ativan 2 mg or more, as needed, Zolpidem.Have had experience with: Tricyclics (useless back then), Paxil, Celexa & Lexapro ( the three caused jitteriness&/or mixed states), Wellbutrin (also jitteriness, more severe), MAOI-B (Emsam patch)(hypomania, fun, but no way I could sit at my desk and think), Neurontin (innocuous), Depakote (too much weight gain, hair loss, sleepiness, lack of energy, and no noticeable benefit), Topamax (I'll only cite the suicidality obsession as of 75 mgs....), Lamictal (no benefit), Zyprexa (heart palpitations and shortness of breath at only 2.5 mgs), Abilify 2 mgs (serious GI pain), Calcium Channel Blockers (weak --- verrrry).

#16 In_Remission_CandaceB

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Posted 09 January 2009 - 12:16 PM

I am on Topamax 150mg as of right now for my migraines. So far I am happy with it. I've been on it for a couple of months, though.

#17 mj1127

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Posted 09 January 2009 - 01:37 PM

I've been taking Neurontin for anxiety (along with Lithium, Lamictal, and Abilify for mood) and it has helped a lot with my migraines. I take 900mg - 300mg tid - though some people need more than that. I haven't gained any weight above what I already gained from Li, and after a period of adjustment when I felt tired, I'm not having any side effects. I still get the occasional headache, but they are much less frequent. It might be worth a try if none of the other options work for you.
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#18 medi

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Posted 09 January 2009 - 01:46 PM

I've been taking Neurontin for anxiety (along with Lithium, Lamictal, and Abilify for mood) and it has helped a lot with my migraines. I take 900mg - 300mg tid - though some people need more than that. I haven't gained any weight above what I already gained from Li, and after a period of adjustment when I felt tired, I'm not having any side effects. I still get the occasional headache, but they are much less frequent. It might be worth a try if none of the other options work for you.

Thanks, MJ. I did try Neurontin at 900 mgs., last year. It was not effective in my case.
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<p>Dx Axis 1: BD II. Had been diagnosed with MDD. Am sometimes also diagnosed with PTSD.Has undergone ECT in 2008.Current Meds: Lithium 600 mg, Synthroid 75 mcg, Inderal 40 mgs, Ativan 2 mg or more, as needed, Zolpidem.Have had experience with: Tricyclics (useless back then), Paxil, Celexa & Lexapro ( the three caused jitteriness&/or mixed states), Wellbutrin (also jitteriness, more severe), MAOI-B (Emsam patch)(hypomania, fun, but no way I could sit at my desk and think), Neurontin (innocuous), Depakote (too much weight gain, hair loss, sleepiness, lack of energy, and no noticeable benefit), Topamax (I'll only cite the suicidality obsession as of 75 mgs....), Lamictal (no benefit), Zyprexa (heart palpitations and shortness of breath at only 2.5 mgs), Abilify 2 mgs (serious GI pain), Calcium Channel Blockers (weak --- verrrry).

#19 medi

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Posted 20 February 2010 - 01:13 AM

I get migraines. Depakote has done wonders. I've only had one migraine in over nine months, and the one I did was during some med changes and slightly scrambled brains. The side effects, however, are enough for me to start trialing Tegretol. Weight gain is the biggest one. Depokote for me came with an inhuman appetite (I mean truly unnatural) which subsided after a few months. Afterwards, I think my matabolism just slowed or something because I continued to gain for a while and the weight has since been impossible to get off. All that said, Depakote does not have side effects for everybody. Some people do not gain weight. As for AD effect, I'm not sure Depakote is the answer... but who knows. My pdoc has had patients who did get a little AD effect from it. Others find it a very depressing med. It's been neutral for me affect-wise.

Tegretol does not have the same efficacy with migraines by reputation, but I am hoping that it will and also control my rapid cycling. We'll see. I may be expecting too much. But I will not know until I try. Same goes for you. Based on your Topamax experience, I'd try Depaote. Since it's for migraine and not bipolar, you should be able to bail on it pretty easily if it's not working out.

By now, I tried Depakote. I think I was like you, eating un-naturally, seeking out the buttery stuff, the sweets, and just eating every hour. That can't be. By the way, I did get a psychological lift from it.
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<p>Dx Axis 1: BD II. Had been diagnosed with MDD. Am sometimes also diagnosed with PTSD.Has undergone ECT in 2008.Current Meds: Lithium 600 mg, Synthroid 75 mcg, Inderal 40 mgs, Ativan 2 mg or more, as needed, Zolpidem.Have had experience with: Tricyclics (useless back then), Paxil, Celexa & Lexapro ( the three caused jitteriness&/or mixed states), Wellbutrin (also jitteriness, more severe), MAOI-B (Emsam patch)(hypomania, fun, but no way I could sit at my desk and think), Neurontin (innocuous), Depakote (too much weight gain, hair loss, sleepiness, lack of energy, and no noticeable benefit), Topamax (I'll only cite the suicidality obsession as of 75 mgs....), Lamictal (no benefit), Zyprexa (heart palpitations and shortness of breath at only 2.5 mgs), Abilify 2 mgs (serious GI pain), Calcium Channel Blockers (weak --- verrrry).

#20 Kurgan

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Posted 10 July 2010 - 05:37 AM

Valproate better than the rest for clusters and migraine (in my case).

I only take it for Clusters, but even think twice now that I can inject sumitriptan to abort.

As for the tension headache... opiates. Others (neuro and psych drugs) have too many side effects. In the UK we use dihydrocodeine a lot. It can cause headache too of course, so watch out. Difficult to get a balance if you aint experienced.
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400mg of lamotrigine really hit the spot for depressive symptoms.

Mirtazapine was the icing on the cake.

I am both crazy in the psych and neuro departments btw. No seizures though.

#21 sc2501

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Posted 01 September 2010 - 01:14 AM

I tried Topamax and while I wasn't suicidal, I was INCREDIBLY lethargic and depressed. My doctor (neurologist) basically forced me to keep giving it a chance for like 10 weeks until I said f-it. I tried an increase in my Lyrica from an anxiety dose to the dose recommended for migraine prophylaxis (300 mg) and it did wonders at least for a few months. I suffer from common migraine anywhere from 3 times a week to once a week. It sucks. I know. Even if you take a triptan in time, you still feel like crap, and it effects mood.

I am now ditching Keppra as I believe it made me suicidal, and upping the Lyrica to an above suggested dosage, hoping it will help with anxiety and migraine prophylaxis. I don't have bipolar, so mood stabilizers aren't that tricky with me, but I haven't had much luck, Neurontin was like a sugar pill.

Have you tried heart medications? Atacand is one that doesn't have psychiatric side-effects and did help me some. Obviously, if you have severe depression, avoid the beta blockers.

I'm sure you know this, but the life-style changes that help my migraine are:
-Eat protein every morning
-Exercise (I fail at this often)
-Be careful with caffeine intake
-Get regular sleep if possible
-Drink TONS of water, and gatorade type bevarages (at least 24-oz) if you feel one coming on. Studies show this can actually stop it in its tracks.

Good luck migraineur!
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#22 In_Remission_Julz

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Posted 10 November 2010 - 06:53 PM

I used to get nasty migraines before starting Lamictal. Aura, headache, violent nausea, photosensitivity, it was the exact same routine each time. I discovered that caffeine was causing them so I stopped using it. Since going on Lamictal I've had a few occasions where I would get one or two mild migraine symptoms and I'd take a Maxalt and be done with it. The shimmering multicolor auras and intense sickness are no more, although the photosensitivity can be severe still.

YMMV as always; in my case I've found this to be an unexpected and much welcomed side effect from my bipolar med!


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