What is the recommended dose of Depakote ER to start with?

Hey dirtybee,

The initial dose of Depakote ER should be 25mg/kg/day. So I would need to know how much you weigh in order to figure out the appropriate dosage. Did he increase the Lithobid and the Seroquell or are those new too?

For seroquel the dose selection is as follows:—When used as monotherapy or adjunct therapy (with lithium (lithobid) or divalproex (depakote)), Seroquel should be initiated in twice daily doses totaling 100 mg/day on Day 1, increased to 400 mg/day on Day 4 in increments of up to 100 mg/day in twice daily divided doses. Further dosage adjustments up to 800 mg/day by Day 6 should be in increments of no greater than 200 mg/day. Data indicate that the majority of patients responded between 400 mg/day to 800 mg/day. The safety of doses above 800 mg/day has not been evaluated in clinical trials.

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The lithobid is generally prescribed in two divided doses of 900mg each. So starting on 900mgs maybe is not unusual though you may need to adjust. Also, be sure to have your blood levels checked frequntly particularly in the early phases of treament.

I have a difficult time with a doctor prescribing too many new medications at the same time because it is very difficult to determine which med may be causing adverse effects. That being said the seroquel is often prescribed along with lithobid OR depakote. The dosage, if this is a starting dose, is exceptionally high for the seroquel.

If you decide to take all four of these medications please be prepared to be very sleepy well into the next day after taking. Do not drive or operate heavy machine until you see how you respond.

Best wishes,

Laurie