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Q: Stability at Lower Med Doses?
I am a 42-year-old man and I'm 6-2 tall, weight is about 220. I've put on
20 pounds of Depakote weight. My psychiatrist has been quite
sympathetic about the situation and we've lowered my daily dose from 1000mg to
500mg. We hope the side effect of weight gain will diminish somewhat, but
my doc isn't expecting it'll stabilize me at a low dose. Blood level at
1000mg was 58mcg, which I know is at the low end of the therapeutic window.
Can some people remain stable at lower than recommended doses?
Dear Glen --
Yes, some people can remain stable at very low doses. The new
"ER" (extended release) version of Depakote seems to promote less
appetite increase and weight gain, so if your symptoms return at the lower dose
you can try going up again using the ER version and see if you can get away
without the weight increase tendency again. Otherwise I go back down to
the lower dose again and add a little bit of another mood stabilizer, like
low-dose lithium, usually.
Dr. Phelps
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