Depakote and vomiting?

[gcvmom]

This doesn't happen a lot, but I'm curious if anyone else has had times where several hours after taking Depakote ER tabs your difficult child vomits them back up?

This has happened about three or four times with us, last night being the most recent. difficult child had taken his Depakote dose and about four hours later, they came back up. He'd eaten a high-fat snack with it (fries and a shake), and I know that can take a while to digest, so I'm wondering if that's the cause -- maybe stuff just sat there too long and started to irritate him?

 

[wakeupcall]

How long has your difficult child been on Depakote? My difficult child tried taking it two different times. The first time he vomited and vomited...for about three days!!! The minute I took him off it, he quit vomiting. Years later the doctor wanted to try it again and then he was very violent on it! Depakote was NOT for him!

 

[tammyjh]

My difficult child was on it a little over a year ago and would vomit once a week like clockwork. At first no one linked it to the medications. but it was the only thing that was different in the routine and it went on for quite a few weeks. It was about every friday friday for 5 or 6 wks. Once she was off it, the vomiting stopped. And yes, it would be about 4 or 5 hours after taking her evening dose and had gone to bed.

 

[bzymomto4]

The 1st 2 attempts I had at depakote I had vommitting of everything , including water. A year later I went back to it for lack of better options - was pretreated with prilosec for a few weeks, then took prilosec and depakote(at 1/2 previous dose) and did well. Able to continue on medication for years.

 

[gcvmom]

Originally Posted By: PamelaJ
How long has your difficult child been on Depakote

PamelaJ,

He's been taking it since the beginning of July. The vomiting has only happened a couple of times, but I'm just trying to sort out if it has to do with what he takes it with or when or what?

Maybe it's got something to do with the stress on the liver if he's taking it with a high-fat food? We tend to encourage him to eat high-calorie (which usually means high-fat) foods because he dropped a LOT of weight (went from 96 to 80 pounds) after stopping Abilify last spring and starting Depakote. He was really, really thin, and he never seems to be hungry.

Why does everything have to be such a puzzle? I dunno....

 

[gcvmom]

Originally Posted By: tammyjh
And yes, it would be about 4 or 5 hours after taking her evening dose and had gone to bed.

OKay, that's interesting! Thanks for letting me know what you've experienced.

Did you notice any other pattern? What did she have to eat on Friday nights? Was it usually the same thing or same type of thing? I'm wondering if there's a connection to the fat content of what he eats with it...

 

[gcvmom]

A year later I went back to it for lack of better options - was pretreated with prilosec for a few weeks, then took prilosec and depakote(at 1/2 previous dose) and did well. Able to continue on medication for years.

That's another interesting story! I wonder why the Prilosec helped -- I mean, what could it have been counteracting that prevented the Depakote from coming back up....

Adding this info to my notes! Thanks

 

[tammyjh]

And yes, it would be about 4 or 5 hours after taking her evening dose and had gone to bed.

OKay, that's interesting! Thanks for letting me know what you've experienced.

Did you notice any other pattern? What did she have to eat on Friday nights? Was it usually the same thing or same type of thing? I'm wondering if there's a connection to the fat content of what he eats with it...

She didn't have anything that was the same although she is fairly self restricted in her diet. Mac and Cheese, peanut butter and jelly sandwiches, veggies, pizza, soups, that kind of thing but never the same meal on those Fridays.

 

[Calista]

My difficult child took Trileptal for 9 months. Every two weeks for 9 months he threw up for 24 ours. A PA friend of mine told us that it builds up in the nausea centers of the brain and causes the vomiting. We took him off just this past Friday and we are now trying Tegretal. Tegretal is almost chemically identical to Trileptal. I hope the difference between the 2 is the diffeence between puking and not. We'll see....

 

[gcvmom]

I wonder if Depakote does the same thing in the brain? That's interesting. I'll have to ask the doctor or pharmacist about it (although, I'm finding that our pharmacist does no better than me reading the package inserts for medications).

Yeah, I hope your difficult child starts feeling better on the new medications :smile:

 

[Sara PA]

The package inserts, also known as "the label" and "prescribing information" contains all the information the FDA requires the manufacturer to tell doctors and consumers. For the newer medications, the inserts/labels/prescribing information give information on clinical pharmacology, studies done on the medications, post marketing reports of side effects, known interactions with other drugs, contraindications, warnings, cautions, dosing recommendations/ranges, as well as indications for use and the populations for whom they are approved. And, of course, those black box warnings if there are any. I'm not sure what else you think a pharmacist -- or even a doctor -- should know about a drug.

 

[gcvmom]

Hi Sara,

In my experience with my local pharmacist (or even our pediatrician, for that matter), he hasn't even been able to tell me about known side effects like enuresis, which I later found is clearly listed in the prescribing info for Depakote ER. Even the pediatrician said "I've never heard of that before" when I asked him about the bedwetting difficult child 2 was having when we increased his Depakote. These are people whom I would expect to have ready access to this type of information. When I asked the pharmacist about husband's profuse sweating since starting Lamictal, and whether it would go away, all I got was a recitation of the packaging information and a suggestion to call the prescribing doctor. That was frustrating for me -- but maybe my expectations are too high.

I guess what I'm expecting pharmacists and doctors to be able to tell me is something they've learned from their experience with the real people for whom they've either prescribed these drugs or filled prescriptions. It's not like they're new graduates and just starting out in their field! They've got years of experience! Or is it just that my family has the swell luck of being in that very narrow population with unheard-of side effects? I'd believe that, too!

I guess what I'm looking for is something more than hearing them recite the drug insert or the PDR. About six years ago, I had a pediatrician tell me that there was "NO WAY" that DDAVP could be causing difficult child 1's extreme aggression, because the PDR didn't report anything about that. Well, when I give my kid a medication, and he suddenly starts to exhibit unusual behavior, which then goes away after I discontinue that medication, and I'm able to repeat this "experiment" with the same results, I kinda think that's a clue that the medication was causing the behavior. He disagreed.

PDRs and package inserts cannot be exhaustive, in my opinion. That's one of the reasons I come here: to gather anecdotal, real-life experiences from people like you and the others here who are in the trenches and living with these kids on these medications on a daily basis.

Whew! I'm on a roll today :wink: Guess I'm gearing up for husband's appointment this afternoon with the neurosurgeon.

Thanks for the feedback!

 

[Calista]

I don't think it's asking to much for a doctor or, especially, a pharmacist to be able to tellyou what you can expect from taking a medication. If all you need to be able to de is read the package inserts then we could all be pharmacists.

 

[STILLjustamom]

They say to take it at bedtime so that you will go to sleep shortly therafter. If he hasn't been doing that, it might be worth a try.

 

[gcvmom]

LOL -- Calista, that's kinda what I was feeling!

STILLjustamom -- when he took it at bedtime, he actually had a harder time falling asleep. psychiatrist suggested taking it after dinner, instead. That seems to work for the sleep part. He's been holding down the medication o.k. the past few days, so hopefully those three separate times where it came back up were just a fluke.

 

[wakeupcall]

I with you. I don't think it's at all too much to ask for a doctor to tell you of the side effects. Good grief! My GP didn't even bother to tell me to take my Levoxyl on an empty stomach. It's not on the label from the pharmacy either. This Board is a wealth of practical information.....and everyone is SO helpful with what has worked or not worked for them....and the side effects from THEIR view!

 

[Lothlorien]

gvc mom,
Maybe this is just a long shot, but since he had a shake and fries right before taking this, I'm just wondering if it's that. I'll tell you why.

My neice and nephews have a slight intolerance to drinking or eating milk products before bed. If they eat those items before about 4 in the afternoon, they are fine. BUT, after 4, for whatever reason, if they eat or drink milk products and go to bed, they wake up vomiting. Every time!

So, before giving up on the Depakote, try eliminating dairy products several hours before bedtime.

 

[gcvmom]

Thanks PamelaJ -- this really IS a great place, isn't it? :smile:

Lothlorien, I agree that it could be an issue with what went in his stomach before he took the medications. I know that fats are harder to digest and it slows everything down -- so maybe a combination of the dairy and the high fat kept those three tablets in there too long.

I'll continue to keep an eye on this...

Thanks everyone!