Depakote: Time Release & Extended Release
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Q:  Depakote: Time Release & Extended Release

U mentioned in a June question that their is no "time release" form of Depakote. I am currently taking Depakote ER (Extended release) I thought this was the same as a time release med. Whats the difference between time release and extended release?

Dear M' --
Thanks for asking; others were probably wondering the same thing -- and, right after I wrote that, a product was reported that I'd not heard of coming, so I'll take this opportunity to inform regular readers who might otherwise go on what I said last time and be mislead...

First, your question: there are 4 forms of "valproate", which is the active ingredient in Depakote:

valproate the original simple molecule, available as a generic

divalproex sodium Abbott Labs makes this combo of two forms of valproate, that's easier on the G.I. tract

Depakote CR this is a "Continuous Release" version of divalproex

Depakote ER this is Abbott's new "Extended Release" version

You're asking about the last two. Until about a year ago, the only "Depakote" (i.e. trade name, not generic) version we had was CR. Then they came out with this ER version, which is clearly a better drug (less tendency to cause weight gain, for example), and does not cost any more than CR, so many of us have just switched over to that one. Caution for some readers: some insurance and hospital formularies have been slow to switch over to ER and may charge a higher co-pay for that version, ironically.

Now, is ER a "time release med'?" Definitely yes, more so than CR, which is more so than valproate. But none of these are the really ultra-time release medication that the woman was asking about, as I recall. I think she was talking about the "depot" medications that last weeks after an injection.

And here's where there is new news: Risperidone, a "new generation antipsychotic" that has some use in bipolar disorder, particularly for Bipolar I, is going to be available as a "depot" medication (called Risperdal Consta, yeesh, have they no shame) very similar to the currently available Haldol and Prolixin shots, but with some of the benefits (and the $$$$ cost) of the new generation medications. Finally an alternative to Prolixin decanoate, this is a good thing.

But as for Depakote, the longest "time release" we're going to see is the new ER version, which can be taken once a day. I hope that answers your question.

Dr. Phelps

Published August, 2003


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