I went on depakote right after diagnosis as part of a clinical trial. They were trying to determine if the combination of lithium, depakote and lamictal would be more effective than lithium and depakote alone for rapid cyclers. The study never was released that I could find so I assume it was not.

Anyway, depakote was good for me but very hard to keep a therapeutic blood level and then I needed a high level to feel good. I think my level had to be about 125 (yet no higher than 130) but it was a fight to keep it above 90. Until I was put on ER we couldn't get a level about 50. Ultimately I wound up on 3000 mg/day and in combination with lithium and various other meds that I didn't take for very long. At that dose my levels mostly were high enough but I was pretty sedated and even more so when I needed to be on APs. I was on it with Seroquel, then Seroquel XR, for quite a while. I was always tired and had trouble getting up for work and generally functioning. I was fired once on the combination partly for being sedated and partly because I worked for really nasty people.

Ultimately I was doing well enough on Seroquel XR that I weaned off Depakote over about 10 months. I lost a lot of the weight I had gained over the years on depakote and had a lot more energy. My thinking was also clearer. It worked when I needed it to but once I was doing ok (ok was the equivalent of great for me with meds until clozapine) on Seroquel I just didn't need both.

My pdoc brought up trying it again once and I begged her not to. It was not an easy drug for me. Honestly clozapine is easier since I know that if I take 3.5 tabs/day I will feel the same day to day. I will sleep too much but I will not feel like my brain is being squished. There are no dose fluctuations for me. I do have the blood draws but I had a lot of those on depakote too since my level just wouldn't stabilize.

It's a good drug and I am glad to know if something terrible happens it is an option again but I hope I never need it again. Or that if I do my body has learned to process it better.