Q:  High Depakote Level & Long Term Effects

My 7 yr. old granddaughter has been taking depakote for bipolar disorder for about a year now. We recently changed doctors who decided to do a depakote level test as she hadn't had one in quite some time. She is taking 500 mg. in the morning and 750 at night. Her test came back today at 150. She has been complaining of stomach discomfort and hasn't had an appetite at all. She normally has a voracious appetite. I feel the level has been high for quite some time.  What kind of tests should be done to see if she has organ damage? What are the long term effects? Do you think I should be as concerned as I am?  

Thank you,


Dear Ms. S' -- 
I'm not aware of any reports of "organ damage", or any long-term negative consequences, of having had a high Depakote level for a long time.  As you've probably learned, many mood experts think that 125 is a better upper-end-of-the-range number than 100 (the latter is used in neurology) for bipolar disorder treatment.  In that light, 150 may not seem quite so high.  

Dr. Phelps
 

Published October, 2004