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<blockquote data-quote="Sara PA" data-source="post: 70382" data-attributes="member: 1498"><p>You should have been getting blood levels done while on the Depakote. Dosage is determined by blood levels. </p><p></p><p>From <em>The Bipolar Child</em> newsletter on mood stabilizers:</p><p></p><p>DEPAKOTE</p><p></p><p>Many children are prescribed Depakote (divalproex sodium) but all too often we receive medication charts from parents or emails reporting that the Depakote dosage was 250-500 mg a day and "it didn't work." Most children will require far higher doses to achieve therapeutic blood levels, and while all children will reach different blood levels at different dosages, it's important to get the right levels and wait a few weeks before making any judgment about the effectiveness of the drug.</p><p></p><p></p><p>Testing Before Treatment:</p><p></p><p>*Medical exam to gauge liver function, blood cell and platelet counts, and serum iron concentrations.</p><p></p><p></p><p>Dosing:</p><p></p><p>Children are often started on a test dose of 125 mg and adolescents on 250 mg, and the doses are gradually increased to obtain a daily target dose of of between 1,000-1,200 mg. Some children will require 1,500-2,000 mg a day to maintain an effective Depakote level. Like Tegretol, Depakote increases its own breakdown and the levels will need to be examined after a month on the medication to see if the level has dropped.</p><p></p><p></p><p>Range of Effective Levels:</p><p></p><p>Many children respond best at levels between 80-90 mg/ml, but some require levels of 100 to 125 mg/ml to achieve adequate symptom relief.</p></blockquote><p></p>
[QUOTE="Sara PA, post: 70382, member: 1498"] You should have been getting blood levels done while on the Depakote. Dosage is determined by blood levels. From [I]The Bipolar Child[/I] newsletter on mood stabilizers: DEPAKOTE Many children are prescribed Depakote (divalproex sodium) but all too often we receive medication charts from parents or emails reporting that the Depakote dosage was 250-500 mg a day and "it didn't work." Most children will require far higher doses to achieve therapeutic blood levels, and while all children will reach different blood levels at different dosages, it's important to get the right levels and wait a few weeks before making any judgment about the effectiveness of the drug. Testing Before Treatment: *Medical exam to gauge liver function, blood cell and platelet counts, and serum iron concentrations. Dosing: Children are often started on a test dose of 125 mg and adolescents on 250 mg, and the doses are gradually increased to obtain a daily target dose of of between 1,000-1,200 mg. Some children will require 1,500-2,000 mg a day to maintain an effective Depakote level. Like Tegretol, Depakote increases its own breakdown and the levels will need to be examined after a month on the medication to see if the level has dropped. Range of Effective Levels: Many children respond best at levels between 80-90 mg/ml, but some require levels of 100 to 125 mg/ml to achieve adequate symptom relief. [/QUOTE]
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