Thursday, December 31, 2009

All about Valproic Acid

I've had a few people ask me about Valproic Acid (it's a less commonly known treatment for Bipolar) so here it is. The information in quotations is from the "Lithium Information Centre from the Dean Foundation for Health, Research and Education."

Info: Valproic is a medication used to treat Bipolar patients who have not responded to more conventional treatments such as Lithium. The brand name is Depakene in Canada and is available in 125 mg, 250 mg, and 500 mg. I currently take 2000 mg (500 mg in the morning, 750 mg at night). My daily amount is based on the type of Bipolar I have, and my body composition (weight, height, etc).

Mania (a very good description I thought) was described as:

"A condition during which one's mood changes from normal to an extremely overactive state, is often marked by feelings of elation, expansiveness or euphoria-a state often described as being "on top of the world". During a manic episode a person may sleep very little, talk very rapidly, and continually take little time of eat, show marked irritability and impatience, and have racing thoughts. Often the manic state progresses to the point where judgment is impaired and contact with reality is lost. It may become difficult to understand what a person is saying. Sometimes poorly thought-out decisions are acted on impulsively, with devastating financial, social, occupational, or legal consequences for self, family, and others. Hospitalization may be necessary for effective treatment.

Depression was described as:

"A condition during which one's mood changes from normal to that of being very low, blue, sad, or unhappy. A person may experience changes in sleep pattern, altered appetite, loss of sexual interest, lack of energy, increased worrying, decreased interest in usual activities, loss of ability to experience pleasure, and difficultly with concentration or memory (though I find that to be true of mania too). Accomplishing normal daily activities, such as going to work, may become difficult or impossible. Depressed people often consider or attempt suicide. Hospitalization is often necessary. At times, episodes are characterized by both manic and depressive symptoms and are referred to ads "mixed states".

Some side effects:

For many patients, the treatment plan is often more difficult to deal with than the disorder or diagnosis. Having to accept a lifelong chronic medical illness is difficult. Some people feel they should people to use their "willpower" or "be like everybody else". I know I've had those feelings; every mentally ill person I know has experienced those feelings at some time or another. The hardest issue is reaching out to be treated and knowing many people will ostracize you. Unlike diabetes (or other physical illnesses), being treated for a mental illness often causes problems with family members, friends and jobs. The mentally ill are called "crazy" (or worse) simply for seeking out help; which keeps many continuing to suffer instead of seeking out help.

Some patients (especially those who tend to me more manic, like myself) miss some of the "good" aspects of being manic-the energy, the euphoria, and they often forget about the "bad" feelings. Many patients also have trouble accepting that they will have to take medication for the rest of their lives (something no one wants to do). And worst than that, (for me anyways), is the side effects. I've come so close many times to stopping my pills because of the side effects. No one can truly understand them unless you've been on them. They are mind altering drugs that can (often) make you feel more crazy than you already are. Plus, the fact that most drugs have only recently been approved for use is rather scary. But the alternative is to live drug-free, where I'd either end up in a mental institution or dead. So I take the drugs.

The blood tests. For Lithium and Valproic Acid you need to have regular blood tests (for me it's about every 3 weeks). This doesn't bother me; I went to nursing school and blood is not a problem. It's a hassle time wise, but that's about it. However, some patients (especially those terrified of blood) hate it, and it becomes a large problem. It is very important that the levels of the medications are measured in the blood so that they aren't too low (and therefore not helping) or too high (and toxic).

Here's a list of common side effects when beginning Valproic treatment:

-nausea (I had this HORRIBLY, I was so sick the doctors kept testing me for pregnancy and then all sorts of other things like a bladder infection, kidney stones, and a burst appendix....I was in the hospital every other day!)
-indigestion (I would go 12 hours of not being able to eat and then I'd be STARVING! And I had strange cravings-pickles and cheese-again why all the doctors thought I was pregnant! :P)
-hair loss

Less Common or Rare

-poor appetite
-diarrhea (another major problem I had)
-abdominal pain (another major problem-I also managed have a ovarian cyst burst at the same it's hard to tell what what causing the problems!)
-weight loss (I wish)
-constipation (sometimes, it was one way or the other)
-menstrual irregularities

It took about a month or so for these side effects to clear. I don't feel any problems now; everything seems to have cleared up. I can't really tell you how I feel mentally because I've come off Seroquel and Paxil in the meantime, and that's totally thrown me, but hopefully in a few months I'll know how I'm feeling.
Anyways, I'm exhausted. Off to bed I go. I plan on doing a write up on Lithium and Anxiety/Social Phobia as well as OCD in the new year.

One more quick note: A woman should NEVER get pregnant on Valproic Acid. Though there are many options for pregnant Bipolar women, Valproic is not one of them. Many studies have proved that severe damage is done to the fetus in the first three months of pregnancy. So use protection!!!

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