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Valproic ACID -- Depakote, Depakene, etc


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If I understand Cunnigham's new study titled "Dopamine Receptor Autoantibodies Correlate with

Symptoms in Sydenham’s Chorea" there are two main findings, first that anti-D1R and anti-D2R, both antoimmune bodies, are elevated. Second is the implcation that like Syndeham's Chorea, eleveted autoantibodies may be helped with valproic acid. Did you use vaproic acid? what was your experience with it?
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I would never give it to my son, or any other psychiatric med. This is an anti-seizure med utilized as a mood stabilizer for bipolar d/o. Another label is Depakote. I am familiar with this med from my work in psychiatric hospital. The side effects are significant. I am really amazed and frankly, disturbed by this info. Can you please provide a link to the article?

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explantion for side-effects I found says that they depend on dosing. presumably, small doses have minimal side-effects.

 

Cunnigham's recent study mentioned in the other post cites this comparsion as note 14, about anti-dopaminaginic drugs.

 

here is the site http://www.ncbi.nlm.nih.gov/pubmed/12131934

and the abstract:

Comparison of the efficacy of carbamazepine, haloperidol and valproic acid in the treatment of children with Sydenham's chorea: clinical follow-up of 18 patients.
Source

Escuela de Medicina, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela. jokar1@telcel.net.ve

Abstract

In order to compare and contrast the efficacy of haloperidol, carbamazepine, and valproic acid in the treatment of Sydenham's chorea a prospective study including 18 cases of this disorder was undertaken. Age of patients ranged from 7 to 15 years. Ten children were female and 8 were male. All but one had generalized, either symmetric or asymmetric chorea. The patients were divided in three equal groups, and were given a standardized dose of each of the drugs built-up over a week. Following therapy, the six children receiving valproic acid showed remarkable improvement, without side effects. Five patients receiving carbamazepine showed improvement without side effects. Only three of the patients that received haloperidol improved. In the 4 cases that did not show clinical improvement after one week of treatment, therapy with valproic acid led to disappearance of the symptoms in a lapse that ranged from 4 to 7 days. Recurrence related to discontinuation of treatment was observed in two patients. In view of the present results we recommend valproic acid as the first choice drug to treat Sydenham chorea.

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My son has underlying history of abnormal nocturnal EEG (no actual seizures) so we have tried Depakote...he was only on it for about 3-4 months. It was the one antiseizure medication that he did the worst on. He became very angry, irritable, more OCD, more ticcish and just changed his entire personality. Gained about 8-10 lbs in 3-4 months!! We stopped it and moved on.

 

I am not one that paints all psychiatric medication with a broad brush as ALL of them being ALL horrible. This was simply not the right medication fit for him. Some medications work well in some and poorly in others. I've learned that it a case of "trial and learn." Not trail and error. None of us are trying to intentionally harm our children--we all want to help them. The only way to see if medication is going to work is to try it. Use a low and slow philosophy...start dosage low and titrate up slowly. I usually go much slower than docs recommend. And, you must give these medication adequate time to show effectiveness---2-4 months is usually enough time for most of them. You will quickly know it this is medication is right fit for your child or not by their response. Works-great. If not-stop and move on.

 

My son has done very well on Lamictal and if you read the side effects on that one... with the SJS potential etc.-- it will scare the bejeezus out of you. However, he has done very well on this one. Not everyone has access to IVIG and/or long term antibiotics. I can understand wanting to 'treat" symptoms with medications (especially, if trying to make research based decisions).

 

My son was glum, rode the anxiety/depression fence, not as happy as a child should be nor seemed to get enough enjoyment out of life (as a child should). This was mixed with intense periods of anxiety, OCD behaviors, ticcy. This all makes for low self esteem and a less than functioning child. I asked Neurologist for what could help his "symptoms"--he suggested SSRI's. I was leery but willing to give it a try. We tried Prozac first and he did very well with improvements in all areas for about 18 months then symptoms seemed to return. Effects 'wore off' so to speak. Neuro states this is common to see. Switched to Zoloft and had good effects for about a year and noticed the winding down of effects. He had gained 3 inches and 9 lbs in 6 months so we increased by just a bit and he has returned to happier, less ticcy, less OCD child. Neuro states he can often switch back to original drug (like Prozac) and notice same good effects. Can go back and forth between just 2 medications patient is known to tolerate and have good outcome for effect.

 

Looking back--we did not increase dosage of Prozac to accommodate growth and he may have done just as well by increasing Prozac dose slightly as he did with increasing dose of Zoloft. Either was, he is still considered on low dose of SSRI. Not at the top of the dosage recommendations, by any means.

 

My whole point is you have to have provider you can work with, know your child, report behaviors/symptoms and be willing to tweak things as needed for these medications to remain and be effective. The doc needs to be knowledgeable in these medications. They are not an end all, be all... but they can be a helpful adjunct to the entire picture. This is but one piece of a much larger plan. Have to have a plan and stick with it for a little while---cannot upset the apple cart every couple months with whole new regimen of meds.

 

Yes, we have tried Depakote and did poorly. Although, others may report their child did wonderfully on it. Not a one size fits all. Have to trial and learn what works for you child. After 9 years at this... this is my take away--now, "give away" lesson :huh:

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This was a med that was offered for my son prePANS dx. I chose the SSRI, Celexa, instead and that was a huge mistake. Dropped that and went to lamictal. It helped. He was on lamictal for a yr and then we weaned him off after IVIG #1 when he was doing so well. I recommend it be given a trial. When DS is flaring, I wish he were still on it, but mostly it's just fine now off it. It has a large margin of safety, if you are not allergic to it. It MUST be titrate up very slowly to avoid allergic reaction. I have a friend on it for seizures. She takes a huge dose and has for at least 10 yrs. works well for her.

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We did psych meds for four years, and we tried depakote. It was not one that worked particularly well for us. We has a pretty brief run and then switched to stavzor, which is similar but newer. Stavzor was better for my daughter except for the horrible side effect of nausea and vomiting.

 

We are not giving an psych meds right now. I often consider it again--like daily--because my daughter is in a terrible state, but I feel like I won't be able to see what improvement comes from if we put her back on them. And she was having pretty decent side effects....a fine tremor, then a large tremor, slurred speech, etc. Good luck.

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  • 2 weeks later...

Ok. I need to read this. Danny's on depakote. It's the only medication so far that has significantly made an improvements. The generic stunk. Finially got him switched to the real one. Huge difference.

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On a neuro spect scan a child who was raging was found to have activity in the brain where there usually are seizures and improved on anti seizure medicine. Unfortunately the computer software went down during our scan so I don't know the exact area of inflammation. Our Dr. finds huge improvement after going off of Dairy. He does that before ANY meds. It was difficult, our son snuck out at night just for a milkshake but it was truly worth it. There is a book, " The Devil in the Milk" by Keith Woodford with studies showing the correlation of mental issues and also type 1 Diabetes with Dairy. Cows in the US are now fed GMO food which may explain the rise in kids with brain issues since 1992.

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We tried Depakote during my daughter's first episode of severe chorea, probably about 4 or 5 days in.

 

When we used it, she was on it for less than a week. At that point, the chorea became basically total body movements, and she was unable to walk unassisted, or stop her head/neck/arm from shaking. She was unable to even read as her head and eyes were moving in different directions.

 

We discontinued it immediately as we were unsure if that was what caused it to get worse. In the end, I believe it had no effect either way, as her next bout of chorea progressed the same way.

 

We also tried Tegretol a few months later. She became quite pale, put on 12 pounds in less than 2 weeks, and fell down the stairs and sprained her wrist. The Tegretol made her so disoriented she was basically nonfunctional. It did seem to reduce some of the movements though, but it was probably because she was so out of it she could barely move. You also need frequent blood tests to check for anemia with Tegretol. We discontinued it, and got PEX about a month later.

 

She was dual diagnosed with both Sydenham's Chorea and Pandas, and we tried basically everything to stop the shaking. Pex was the only thing that really helped.

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