From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Depakote ER (extended-release divalproex sodium) is a long-acting formulation of valproic acid that is effective in treating seizures, bipolar disorder, and migraines, with a dosing range of 500-2000 mg per day, and its use is supported by the most recent study 1.
Key Points
- Depakote ER is typically taken once daily, with the extended-release formulation maintaining more consistent blood levels throughout the day compared to immediate-release Depakote.
- The medication works by increasing levels of gamma-aminobutyric acid (GABA) in the brain, which has an inhibitory effect on nerve transmission, helping to stabilize abnormal electrical activity.
- Common side effects include nausea, drowsiness, dizziness, and weight gain, and regular blood tests are necessary to monitor liver function, platelet counts, and drug levels.
- Patients should take Depakote ER with food to reduce stomach upset and should not crush or chew the tablets as this would destroy the extended-release mechanism.
Evidence-Based Recommendation
The most recent study 1 found that valproate was more effective than placebo in preventing new bipolar disorder episodes of mania or depression, and not significantly different from lithium, second-generation antipsychotics, or other anticonvulsants.
Clinical Considerations
- When starting Depakote ER, dosing should be initiated at lower levels and gradually increased to minimize gastrointestinal side effects.
- The choice of Depakote ER should be based on the patient's history of response and personal preference, as well as the clinician's previous experience and pharmacokinetic properties.
- Regular monitoring of liver function, platelet counts, and drug levels is necessary to minimize the risk of adverse effects.