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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by AnneL on November 10, 2007, at 12:25:26
I am quite disappointed that I have to taper off Depakote after being on it for nearly a month for Bipolar disorder. I have seen many improvements and the side effects were livable - but my liver does not like Depakote! My liver enzymes went up considerably since my last dose increase (total 750 mg. and in the therapeutic blood range).
I have an appointment on Tuesday to discuss another med change and am looking at lithium, Tegretol, Trileptal or Seroquel as possibilities. I cannot tolerate Abilify (horrible akithisia).
Anyone with any experiences with the above meds? :) AnneL
Posted by Phillipa on November 10, 2007, at 16:51:55
In reply to Bummed! Depakote caused liver enzymes to rise!, posted by AnneL on November 10, 2007, at 12:25:26
I've taken trileptal but at a very low dose only l50mg for unipolar depression. So sorry your enzymes are up. Was the depakote working for you? Phillipa
Posted by AnneL on November 10, 2007, at 19:22:48
In reply to Re: Bummed! Depakote caused liver enzymes to rise! » AnneL, posted by Phillipa on November 10, 2007, at 16:51:55
Hi Phillipa,
Yes, the Depakote seemed to have been working nicely in conjunction with Effexor + Wellbutrin. I really did not anticipate having any problems with my liver enzymes, but I understand that Depakote is pretty hard on the liver for some.I see my pdoc on Tuesday and will be discussing Trileptal or Tegretol. My understanding is that Trileptal is a weaker version of Tegretol without the (rare) adverse effects (agranulocytosis, aplastic anemia. Both Trileptal and Tegretol are not nearly as researched as lithium or Depakote, but Europe has been using Trileptal for 10 years now. Thanks for your reply! :) AnneL
Posted by Phillipa on November 10, 2007, at 20:00:35
In reply to Re: Bummed! Depakote caused liver enzymes to rise! » Phillipa, posted by AnneL on November 10, 2007, at 19:22:48
Trileptal is tegretol minus one oxygen ion. At higher doses maybe it will work. I had elevated liver enzymes last summer and it messed up my thyroid and all my blood work. Hope you get them down quickly and good luck. Phillipa
Posted by AnneL on November 11, 2007, at 11:40:02
In reply to Re: Bummed! Depakote caused liver enzymes to rise! » AnneL, posted by Phillipa on November 10, 2007, at 20:00:35
Hi Phillipa,
I have been following your thyroid issues and I know how hard it is to get to a euthyroid state. Are you hypothyroid or hyperthyroid? I had Hashimoto's thyroiditis (autoimmune disorder) after the birth of my first child some 23 years ago. I have been on levothyroxine 100 mcg for about 10 years and for the last 13 years have been on 150 mcg.One of the problems with certain meds is that they can either cause actual problems with thyroid function or, alternatively, they can skew the results of thyroid function tests which makes it difficult to interpret! :) AnneL
Posted by kaleidoscope on November 11, 2007, at 13:02:51
In reply to Bummed! Depakote caused liver enzymes to rise!, posted by AnneL on November 10, 2007, at 12:25:26
Hi
Depakote causes raised liver enzymes very frequently, a problem which is normally transient and does not generally represent a serious problem. Of course, Depakote can cause severe liver damage - it's certainly not common though. With Depakote, a prolonged prothrombic time (a blood test) represents liver injury, whereas raised liver enzymes don't really mean that much. Most patients with raised liver enzymes on Depakote are asymptomatic.
Here are the guidelines from the UK.....
Liver toxicity
Liver dysfunction (including fatal hepatic failure) has occurred in association with valproate (especially in children under 3 years and in those with metabolic or degenerative disorders, organic brain disease or severe seizure disorders associated with mental retardation) usually in first 6 months and usually involving multiple antiepileptic therapy. Raised liver enzymes during valproate treatment are usually transient but patients should be reassessed clinically and liver function (including prothrombin time) monitored until return to normal—discontinue if abnormally prolonged prothrombin time (particularly in association with other relevant abnormalities).
Posted by AnneL on November 11, 2007, at 17:24:20
In reply to Re: Bummed! Depakote caused liver enzymes to rise! » AnneL, posted by kaleidoscope on November 11, 2007, at 13:02:51
Hi Kaleidoscope!
This is the same thing that my primary care doctor said! He said that liver enzyme elevations can be transient as well and to talk to my pdoc. My pdoc has lowered my dose from 750 mg. to 500 mg.
I think my pdoc wants to pull the plug on the Depakote because it is too much work for her! I have an appt. with a new pdoc in January. I'll ask my current pdoc if she will consider keeping me on Depakote, ordering the blood test (is it a PT or PTT?).
Thank you so much for your input! :) AnneL
Posted by Phillipa on November 11, 2007, at 18:13:22
In reply to Re: Bummed! Depakote caused liver enzymes to rise! » Phillipa, posted by AnneL on November 11, 2007, at 11:40:02
Hi Anne yes we have something in common mine goes down below l now. Seeing an endo but switching in December as the other group is associated with the better hospital. I was stable for nine years on 125 of synthroid now he keeps switching it a pain. So a new doc is in order. Hopefully your new pdoc will be great. Phillipa
This is the end of the thread.
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