Q:  Is there a "time-release" option avail for drugs like depakote and Zyprexa? My son is in denial and is refusing to take the meds though he needs them. Or is there an injection system for his meds?

Thank you,
Dennis

Dear Dennis -- 
Sorry to be slow in getting to your question.  You've probably figured out by now that: 

1. No, no "time-release" option for either.  The lingo for this in the business is "depot" medication, from the French term for storage:  the medication is connected to a molecule that makes it hang around in muscle tissue and slowly leak out.  A medication that cannot be connected to the storage molecule in this way cannot be made into a "depot" medication, and that's unfortunately the case for Depakote.  

As for Zyprexa, I think it has the same limiting factor in this way, but they have made a version that can be injected, but it is not "depot" because it leaks into the bloodstream very quickly and is gone in the same time as oral medication.  

However, for Zyprexa there is an oral form that dissolves so quickly it's pretty impossible to "cheek it", i.e. to hide it under the tongue or in the cheek and spit it out later.  This "Zydis" form is very helpful for people who don't want to take it, but it does require some person like you or somebody to be there every day to hand your son the pill and watch him put it in his mouth.  And of course that requires that he understand that if he refuses to do so there will be some consequence like going back to hospital or jail or something, which is another complex matter but has been done for some people. 

There is no "depot" system for any of the medications we like to use in bipolar disorder, only for two of the older antipsychotics that it's no wonder people don't want to take.  We desperately need a "depot" for Depakote or Zyprexa or things like that, but as far as I know there is nothing like that on the horizon.  

Dr. Phelps

Published June, 2003