I was taking Depakote for PCS headaches for 3 months. First the Neuro told me to double the dose overnight because I was not getting better fast enough for him. That made me feel awful and raised my blood pressure so I told him I was going back down. He disagreed with me but said go ahead. Now he wants me to stop taking it altogether and start Topamax next week. I asked him if stopping depakote cold turkey was safe and he said it was, but from what I can see on the net it's not a good idea. Any suggestions out there?
Can I stop taking 500 mg. of Depakote cold turkey? My Neuro told me it was ok?
Question posted by mibagents on 7 April 2012
Last updated on 5 April 2020
"t is always recommended to conduct a gradual taper off of anticonvulsant medications. Since this is a drug that affects various neurotransmitters as well, it is important to gradually taper as opposed to quitting “cold turkey.” By slowly tapering, you are giving your body and brain some time to gradually adapt as you get used to functioning with less of the drug.
If you quit cold turkey, you may experience more debilitating withdrawal effects for a longer period of time. Quitting cold turkey essentially strips your nervous system of a stimuli that it was used to receiving for a long period of time. In some cases, by not tapering, it is thought that you may shock the nervous system and it may take even longer to readjust to functioning without the drug.
Most sources suggest tapering at a rate of 20% to 25% every 2 weeks. You could taper slower or quicker, but this makes roughly for about a 2 month withdrawal period. Even 25% may be too quickly for you if you have been on the drug for a long period of time at a high dose. Take the time to work with a professional and come up with a custom plan to minimize withdrawal symptoms. To be on the safer side you could even reduce at a rate of 15% every 2 weeks."
"Below are a list of possible symptoms that you may experience when coming off of Depakote. Keep in mind that you may not experience every symptom listed below and that the severity of what you experience will largely be based on individual circumstances.
Anger: Some individuals report feeling anger to the point of rage when they initially come off of this drug. It may have to do with the fact that the drug itself tends to elicit a calming response – inhibiting the reuptake of GABA. When stopped, this may lead a person to feel more angry than usual.
Anxiety: If you notice that you feel more anxious and less relaxed, it’s largely due to withdrawal. It is pretty common to experience anxiety and have anxious thoughts when you initially stop this medication. If you didn’t have anxiety prior to taking this drug, you should gradually become less anxious over time.
Bipolar relapse: For those who have bipolar disorder and are on the drug to help control manic cycling, you may experience mania when you quit. When you take away the drug that was helping control the cycling, it is possible to experience a shift in mood.
Concentration problems: A very common problem that people report during the first couple weeks of withdrawal is concentration problems. These can be more severe if you quit cold turkey or taper too quickly. In general you may have a difficult time staying focused and completing work or school-related tasks.
Confusion: There are a combination of symptoms that contribute to feeling confused. These include things like: foggy thinking, poor concentration, mood swings, memory issues, and physical symptoms. The confusion should ease up as your brain gradually begins to function without the drug.
Depression: Another common symptom to experience is that of depression. Although Depakote does not prevent cycling into depression, coming off of it can lead a person to feel depressed. It could be in part due to neurotransmitter changes, particularly involving GABA.
Dizziness: Perhaps the most common symptom associated with the withdrawal process is that of dizziness. Many people report feeling extremely dizzy and or have sensations of vertigo. If you feel dizzy, just know that it will improve in time. If you quit cold turkey, this may be significantly more severe.
Fatigue: Do not be surprised if you feel pretty tired with low energy for the first couple weeks after you quit this drug. Do your best to work with the energy that you’ve got and eventually you should notice your energy levels increase.
Headache: Many people experience general headaches when they stop this medication. Individuals that were taking Depakote for migraines may notice rebound migraines upon discontinuation.
Insomnia: This drug tends to calm people down and can make individuals sleepy. When you discontinue, you may notice that you experience an inability to fall asleep at night. This may be in part due to anxiety and/or inadequate GABA.
Irritability: It’s pretty normal to feel irritable when withdrawing from this drug. Expect the irritability to slowly decline in intensity over the course of a few weeks following your last dose.
Mood swings: It is common to experience general mood swings (non-bipolar) upon discontinuation of this medication. One moment you may feel very angry, the next depressed, and the next very anxious. Just know that you may experience some general fluctuation in moods as you recover from withdrawal – these will eventually subside.
Muscle weakness: Some people tend to experience muscle weakness and/or pains when they initially quit this drug. This weakness should improve gradually over the course of a few weeks until you no longer feel weak.
Nausea: In some cases, people end up feeling nauseated if they taper too quickly or during the first week of withdrawal. This nausea may be unpleasant, but keep in mind that it will eventually subside.
Seizures: If you have epilepsy you may experience rebound seizures during withdrawal if you remain unmedicated. It is always important to make sure that you slowly taper from AED’s or you could experience a seizure. If you are unsure of a good tapering protocol, talk to a professional.
Sleep changes: You may experience changes in your sleep patterns during withdrawal. In other words, you may have difficulty falling or staying asleep or you may sleep too much. You may also have difficulty sleeping at normal times (e.g. sleepy during the day and unable to sleep at night).
Suicidal thinking: In some cases, the depression that people deal with during withdrawal can lead to suicidal thinking. If you are feeling suicidal and haven’t felt this way before taking the medication, you should recover to normal thinking in some time. In the meantime, be sure to see a therapist and talk about your feelings if they are extreme.
Tremors: Withdrawal can lead some individuals to experience shakes or tremors upon discontinuation. These can be minimized if a proper tapering protocol is followed, but if a person quits too quickly, the tremors may be severe.
Vision changes: It is common to experience vision changes while taking the drug. Some people experience similar vision changes when they withdraw as well. Over time your vision should return to normal functioning – give it some time.
Weight loss: Since many people gain weight when they take Depakote, it should be obvious that they are going to lose it when they stop taking it. If you gained weight while on the drug, you should eventually lose most of it as time continues to pass. The weight loss will not be immediate, but should occur gradually."
In a word, NO. You have to taper off it and even then your gonna feel something. I was also on it for 3 months and have tapered it 125 mg every week until I hit zero. The worst withdrawal was at the last 125 mg. I have been off all depakote for 12 days now and am still having bad side effects like anxiety, headache, depression, body aches, face flushing and heart palpitations. I called the CVS pharmacist and asked them how long the withdraw could last. She said 7-14 days after the last dose.
I have been taking Depakote in varying dosages from 500 mg. to 1500 mg. per day as a Migraine preventative for several years. The Depakote was causing severe hand tremors, and weight gain.
I stopped taking Depakote at the 1000 mg. dose cold turkey with no adverse effects.
It wasn't doing a thing for my migraines and the hand tremors have stopped,
now just working on getting off the extra 30 - 40 lbs. that I added.
Hi mibagents... I've taken depakote for several years; 500mgs & 750mgs (now take 1,000!). But on at least three occasions, I did stop it just like that - cold turkey - and I suffered no adverse affects. Yes it CAN have the potential to cause seizures, but I think I'd go with the doc's instinct's - most likely statistically this occurance is relatively rare; and in the times I did this, nothing of this nature happened. Whatever you decide, good luck! Kathleen
Depakote is used for many symptoms, one of them being migraines as you have pointed out. As you take 500mg/day I assume it's 250mg two times daily. In the three month period that you have stated taking the medication your body has become accustomed to the dosage even though you are having adverse effects that warrants a medication change. I am in no position to second guess a neurologist BUT in my 10+ years of a practicing RN it has never, ever, been advised by my physicians to stop this type of medication abruptly. It could have very adverse reactions... one being seizures that can be very hard to control and potentially life threatening. Even though you are not taking this medication for seizures there is still the possibility of it happening to you. In my opinion you should speak to your MD and tell him your concerns and make a plan to cut down slowly. A possible solution is to cut your dose in half, and then take an even lower dose until it is slowly leaving your system.
Work with your MD and advocate for yourself. You are the patient and if you have any concerns at all a good Dr. will respect those concerns and together you can come up with a plan that you are comfortable with. I urge you not stop abruptly, you may have no side effects from doing this as suggested by your doc but as a general rule of thumb it is NOT recommended. Stick to your guns, play it safe! You wouldn't have posted this question if you didn't have questions about your treatment. You could stop suddenly and experience no side effects, a great outcome... but what if you drew the short straw unnecessarily... Good luck to you and follow your instincts as well as educating yourself as much as possible!
- Depakote uses and safety info
- Depakote information for Healthcare Professionals (includes dosage details)
- Side effects of Depakote (detailed)
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