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Depakote question
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<blockquote data-quote="seriously" data-source="post: 477311" data-attributes="member: 11920"><p>If he has a history of active homicidal impusles/actions while on Depakote then I would say he should NOT be on it at all and if there's a way you can contact the pharmacy and psychiatrist to make sure they know of this history - then you should do it. Right away. And tell him he needs to tell the doctor about his reaction and have the pharmacy list it as an allergy.</p><p></p><p>Bipolar disorder is generally thought to be on a spectrum or continuum with Unipolar depression. So it's not so much like you have BiPolar (BP) or you don't have BiPolar (BP) if you have mood lability. It's more a matter of degree. Is it severe enough to meet criteria for a BiPolar (BP) diagnosis according to the DSM or not? that is the diagnostic question so the doctor can fill in the box with the code that gets the bills paid. In practice, mood lability - even shifts from normal (euthymic) to depressed may meet this description- is probably best treated with a trial of a mood stabilizer. Depakote, Lamictal, and Lithium are all first line treatments for mood instability. Many people also have success with anti-psychotic medications.</p><p></p><p>Normally you don't want to mix Depakote and Lamictal except under the attentive care of a very knowledgeable psychiatrist. Because they can interact in nasty ways. That's mostly because of the idiosyncratic metabolism of Lamictal. How fast/slow Lamictal is processed by your body varies a lot from one person to another, which makes potential interactions with other medications hard to predict reliably. But that doesn't mean that they can't be used together. I was on both for a little while but continued to have problems with the Depakote so we dropped it completely.</p></blockquote><p></p>
[QUOTE="seriously, post: 477311, member: 11920"] If he has a history of active homicidal impusles/actions while on Depakote then I would say he should NOT be on it at all and if there's a way you can contact the pharmacy and psychiatrist to make sure they know of this history - then you should do it. Right away. And tell him he needs to tell the doctor about his reaction and have the pharmacy list it as an allergy. Bipolar disorder is generally thought to be on a spectrum or continuum with Unipolar depression. So it's not so much like you have BiPolar (BP) or you don't have BiPolar (BP) if you have mood lability. It's more a matter of degree. Is it severe enough to meet criteria for a BiPolar (BP) diagnosis according to the DSM or not? that is the diagnostic question so the doctor can fill in the box with the code that gets the bills paid. In practice, mood lability - even shifts from normal (euthymic) to depressed may meet this description- is probably best treated with a trial of a mood stabilizer. Depakote, Lamictal, and Lithium are all first line treatments for mood instability. Many people also have success with anti-psychotic medications. Normally you don't want to mix Depakote and Lamictal except under the attentive care of a very knowledgeable psychiatrist. Because they can interact in nasty ways. That's mostly because of the idiosyncratic metabolism of Lamictal. How fast/slow Lamictal is processed by your body varies a lot from one person to another, which makes potential interactions with other medications hard to predict reliably. But that doesn't mean that they can't be used together. I was on both for a little while but continued to have problems with the Depakote so we dropped it completely. [/QUOTE]
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