
Jun 11, 2014, 03:08 AM
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Here is a webpage, written by a psychiatrist, that I found helpful:
valproate for bipolar disorder
An excerpt regarding weight gain:
Quote:
Preventing weight gain
Weight gain is very common at medium or high doses, but not common at 1000mg or less. Fortunately, it does not usually “sneak up” on you. You will notice a huge increase in appetite first. You want to eat frequently, eat a lot, and even feel hungry just after eating.
Fortunately again, the appetite increase is like a light switch: it’s either “on”, or “off”. If you notice your appetite go up, then call your doctor and ask about moving the dose down. As you lower the dose, the “switch” goes “off” for almost everyone (rarely, some just have to stop).
Recently the makers of Depakote produced an extremely slow release version of their pills they believe causes less trouble with this unusual appetite increase, and thus does not cause weight gain. If Depakote ER is available to you at the same cost as divalproex, or close, it may be worth using the ER version . People can get their dose higher with this version than with divalproex, in most cases, without causing weight gain. And get the same benefit in terms of symptom control. So overall I think the ER version is indeed slightly better, but only barely, and for most people probably not enough to justify a much higher cost (if, as will be true for most people with insurance, the generic divalproex carries a much lower co-pay than the trade name Depakote ER. It might be worth finding out if that's true for you: how big a difference would it be?)
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