Talk:Valproate semisodium

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Contents 1 Typical dose 2 Vivid Dreams 3 Role in personality disorders 4 Weight gain

[edit] Typical dose

What is a typical dose? Sideburnstate 19:37, 16 July 2007 (UTC)

From The Drug Information Handbook, 15th ed., "max recommended dosage is 60 mg per kg per day" for mania, for ER, "max recommended dose 60 mg per kg per day", also for mania. I am not instructing you on how to take this drug, only giving you information. Instructions should always come from a doctor.Jackkoho (talk) 19:22, 28 March 2008 (UTC)

Could someone explain, why is divalproex used mainly as mood stabilizer? It's only a form of valproate, its pharmacological active principle is the valproate anion just as with sodium valproate, calcium valproate or valproic acid. It has exactly the same pharmacodynamics as valproic acid or salts thereof. It's quite strange, that it is many times more expensive than generic valproate and that the psychiatric/neurologic indications of these compounds (valproic acid and all of its salts) are not he same. In continental Europe, the indications spectrum of all valproates including divalproex are the same, as well as prices (generics beeing somewhat cheaper than originals like Dépakine/Ergenyl and Convulex).--Spiperon 01:12, 22 October 2006 (UTC)

The separate marketing of divalproex or valproate semisodium (Depakote) for psychiatric conditions and valproate or valproate sodium (Epilim) for neurological conditions by different branches of the same company may be specific to the UK, where Epilim has been available for about 30 years and Depakote for less than ten. The older formulation is out of patent: as there are cheap generic versions, it is not worthwhile for any one company to market it intensively.

According to the British National Formulary or BNF, 52nd edition, Sodium Valproate (Epilim, etc) is indicated for "all forms of epilepsy." The newer (to the UK) drug Valproic Acid (Depakote) is available only as one brand, with no generic competition. and the BNF says it is indicated for "acute mania associated with bipolar disorder." The BNF adds "Sodium valproate has also been used, but it is unlicensed for this indication." These licences apply to marketing rather than to clinical use, but they mean that the older formulation can not be promoted for mania, whereas the newer drug can. When the similarity is pointed out to the Depakote representatives, they may claim a lower incidence of side effects, making it easier to tolerate high dosage, but this seems to refer to gastric irritation. If asked whether Depakote might be preferable for epilepsy as well, they may say that they are not authorised to promote their drug for that purpose. The BNF says, under side effects of Valproic Acid, "See Sodium Valproate."

Perhaps there has been some compromise with the licensing authority, allowing the new more expensive formulation to be licensed for psychiatric use on the understanding that there will be no campaign to change the large population of cheaply treated epileptic patients to the more expensive version. Such a compromise would not be in the public domain, and could not be proven or referenced. Even if there is enough published research evidence to justify the use of the cheaper version in psychiatry, the original manufacturer would not pay for a new product licence for the old drug now that its generic competitors could benefit. NRPanikker 00:51, 16 November 2006 (UTC)

[edit] Vivid Dreams

1 to 10% of people taking this drug report abnormal dreams, according to the Drug Information Handbook, 15th ed. Jackkoho (talk) 05:15, 29 March 2008 (UTC)

This medication gives me very vivid dreams, every night. Just thought I'd add that note. Jackkoho 16:41, 6 February 2007 (UTC) Me too. Sideburnstate 14:53, 1 August 2007 (UTC)

[edit] Role in personality disorders

In Wright's Core Psychiatry (2nd ed, 2005, ISBN: 0 7020 2718 9, page 185), it is mentioned that valproate semisodium may have action in treating personality disorders. Does anyone know any more about this? Ged3000 (talk) 23:39, 17 January 2008 (UTC)

Some doctors are using depakote or sometimes depixol off-label as a "mood stabilizer" for some types of personality disorder. This is usually to prevent very low mood. Dan Beale-Cocks 22:03, 15 March 2008 (UTC)

[edit] Weight gain

This side effect of weight gain commonly known by psychiatrists. 1% to 10% report weight gain and increased appetite. Also from the Drug Information Handbook, 15th ed. Jackkoho (talk) 19:20, 28 March 2008 (UTC)