Any Thoughts on Depakote or Lithium? ***¡Advice Please!***

Saw NewVCB last Wednesday morning.

Not much to report, really, and even if there was, as you’ll be able to tell from the appalling calibre of the following, I’m still not really in the form needed to competently review it.

She asked how things were and told her everything was fucked, thanks to my idiotic decision to reduce my Seroquel dosage. She checked that I was had gone back up to the 600mg dose, and I confirmed that I had, and had been doing so for about a fortnight.

Long and the short of it is that she claims it’ll take up to six weeks back on the high dose for things to start to improve. Wonderful. Well done, Pandora. It would be less annoying if it wasn’t my own fault. She encouraged me not to berate myself – she says patients do it all the time, and that if nothing else, it demonstrates to me what I do and don’t need. Well, maybe so – but I did this years ago when taking Fluoxetine, and should have learnt from that experience to leave such things to the quacks. But nooooooo. I know better, don’t I? Twat.

Anyhow, naturally she asked why I’d decided I’d half the dose. I explained about the horribleness of the hangover effects and the preposterous weight gain. I said that I’d be willing to tolerate the former for now (and as she noted, if and when I go back to work, I am more likely to get a ((post-hangover)) afternoon part-time job anyway, since most part-timers prefer mornings), but that I hated the weight gain issue because I was down to a size 16ish at one point (I hadn’t been that size since I was 16), and that having put most of it back on was pretty soul-destroying.

Her plan, then, is to wait until my mood has re-stabilised on my current medications (which seems unlikely to ever happen to me right now, but she opines to the contrary), and then we can look at how to play this in the long-term. She does, to be fair, acknowledge that even ignoring the physical issues surrounding my gargantuan size, it’s not good for my mental health to see 14 rolls lopping down around my knees, hiding even the briefest glimpse of my toes and their ingrowing nails. What she has suggested is reducing, though not eliminating, the Seroquel – and then adding in a mood stabiliser to make up for the loss of those same properties from said drug.

She specifically named Lithium and Depakote, though she expressed a mild reluctance regarding the latter; she laughed and said that she knew I was filled with abhorrence at the mere mention of breeding, but that nevertheless, she had to be very, very careful about the prescription of the thing to ‘fertile females’ on a ‘just in case’ basis. Apparently it can seriously fuck up a foetus/embryo.

I really don’t give a fuck about that, as – as she rightly noted, though I’m not sure how she figured it out as I don’t recall ever discussing it with her – I fully intend to never become pregnant. However, I think I read somewhere that it can interfere with the mini-pill, which I take as a contraceptive and fuck-off-menstruation-and-related-pain medication. A quick look just now has suggested that it doesn’t stop it working, but could increase levels of hormones in one’s body. Which could be a bit wank as I’m not unconvinced that oestrogen has an effect on mentalism, specifically depression (sometimes of the particularly vile variety known as ‘agitated’).

She did say, though, that she would prescribe it (regardless of my presumed ability to conceive) if she thought it best, on the balance of the foetus issue versus its active psychiatric indications. I was initially quite encouraged by this, because I’m not sure how I feel about Lithium: I’ve heard of others gaining weight on it (and one friend was constantly ill whilst taking it), so what would be the point in cutting the Seroquel (which I know works)? So, I thought, bring on the Depakote. Except that, since then, I’ve read the article on it on Net Doctor and see that it too can cause weight gain!

So, maybe either it or Lithium would mitigate the undeniably shitty hangover effects of Seroquel, but it’s quite possible my main concern would not be assuaged in any way. So what would be the point in modifying my current cocktail which, whilst problematic, has shown itself to work very well in terms of its indicated usages, only to find myself at the mercy of the same cunty side effects I’d hoped to avoid anyway?

All that said, I have known people to take mood stabilisers (Lithium in particular) who’ve found that it completely changed their life. Indeed, the Net Doctor article on it states that it’s a very good medication to take to boost the effects of pre-existing anti-depressants. So if I could get my depression and its related anhedonia/lethargy/etc to sod off (it’s never really gone away – it’s only got a bit less shit), then I might be more willing to leave the house and get some exercise to combat any extra weight anyway. But that’s a bit of a punt, really.

Have any of you any experience of Lithium and/or Depakote, and if so, what’s your view on it/them – both in terms of how they help (or don’t) psychologically, and on what the side effects are? If you take an alternative mood stabiliser (whether a ‘true’ mood stabiliser or an anti-convulsant) and you’ve found it useful and/or lacking in side effects, could you tell me a bit about it too please?

NewVCB also mentioned other anti-psychotics such as Risperidone, which typically have lesser weight issues than Seroquel. However, as a form of anti-compensation for that, you lose the mood stabilisation, so one such medication would again presumably be needed in that circumstance.

Despite my dreadful mood, I managed to crack a joke during the appointment, and was pleased to make her laugh. She asked me about suicidal ideation, and I told her all I could think about was my body flying off the Golden Gate Bridge or the high-rise apartment blocks close to my house.

“But don’t worry,” I added drolly. “I suffer from vertigo*, so…”

(* And it is ((usually, though not always, height-triggered)) vertigo, as opposed to acrophobia. I don’t really have the latter, bizarrely).

She laughed out loud, caught herself on and apologised, then started laughing (almost hysterically) again. I told her it was meant to be humourous and to laugh away. I like humour in this arena. I remember once ages ago that C cracked a joke (oh look – it was my very first therapy post. How quaint) about how my footballing allegiances were not at all good for my mental health (especially true that fucking season) – a comment made viscerally, for which he then apologised. Fuck that. Don’t apologise! Joke away. I mean, if you didn’t laugh, you’d have to fucking cry.

Anyway, medication issues aside, I handed NewVCB a copy of my last post, and that coupled with her usual questioning determined that I am “very clearly” in the midst of a major depressive episode. However, at least A and Mum are usually about somewhere, and my suicidality is operating “at fantasy level”, so there is unlikely to be any “danger”. I’d say that the lack of danger comes more from avolition and apathy rather than anything else, but there you have it. I shall, most likely, remain alive for the next while.

As I left the appointment (having managed to blag myself a script for Diazepam – which frankly I don’t particularly need, but insurance is always good) she said, for the second time since I first met her, “nice to see you, Pandora.”

Incidentally, the first time she gave me a complimentary goodbye of this nature, I was also similarly mental to last week (and both occasions were caused by fluctuations in medication, rather than being distinct ‘episodes’ in their own right). Why do I find that probably coincidental and innocuous fact so intriguing and revealing?

In other news – I haven’t written anything in the last week…BUT! I’ve had this laptop completely closed – it’s literally not been open once – since…fuck, I don’t know, last weekend? Although I have tweeted some articles and suchlike, I haven’t checked Twitter at all (ditto G+ and the odious Facebook). In this complete abandon of social media, I’ve been working on The Book. I’ve not written anything, as noted, but I have been studying the distance learning writing course I enrolled on when I first went off work a few years ago, and have been especially concentrating on the modules on novel composition. Much of it seems obvious – although this blog is factual and autobiographical, sometimes the narrative of posts takes on a tone similar to fiction, so I feel I have some pre-existing understanding of the idea. However, there has also been a lot of benefit in what I’ve studied to date, and I feel cautiously confident about The Book and its plot at the minute.

Furthermore, in my absence from internet sociability, for some reason I’ve been internally bombarded with quite a number of creative fictional ideas that I think I can turn into short stories, novellas, or perhaps a second The Book. There’s one about which I’m especially hopeful, which was garnered from a disturbed, haunting dream this very morning. At least nightmares have some purpose!

On Thursday, Wendy Perriam, whose excellent book Broken Places I reviewed for Mind, emailed me to thank me for said review. This was a wonderful buoyancy both for my own sake and for that of my writing (which Wendy was kind enough to compliment, which was incredibly flattering coming not just from a published author, but also from a published author who I hold in high regard). I asked her for a few tips, which she kindly gave me, and it’s added to my sense of ‘I can do this and it won’t be completely crap’. I’m not undaunted by any means, but neither am I totally petrified of my own potential incapacity.

The weekend was quite good. I’d been apathetic about going to one of our regularly organised poker nights on Friday because that meant fucking seeing people, but in the end it was fairly good craic – and guess what? Muggins won 😀 It’s my first win in a long time but it sees me atop the leader board. I’m the only woman in the whole group, yet the stats show me as the best player. Suck it up, gents!

On Saturday we met W, A’s best friend who was back in Norn Iron from England for the weekend, and ended up spending all day talking complete and utter bollocks and laughing at puerile nonsense. It was good. In keeping with what’s been occupying my own life lately, I suggested a writing challenge to W and A, an idea that both seemed to embrace for their own reasons of escapism and intellect. As well as just being fun (what even is that?), I think this could be useful in terms of my self-imposed deadlines – if A and W are in competition, I am going to be more driven to compete within this cause myself.

So, all in all, ostensibly things are good – but the reality, of course, is far from as black and white as that. I’m back into a firm agoraphobic, hide-in-the-house-and-brood-with-the-blinds-closed mode. But I’m keeping up with the studying element of my (hopefully) soon-to-be The Book, so there’s a sliver of a silver lining (try saying that after six pints of pale ale).

I’m seeing Christine tomorrow. She asked me, the last time I saw her, to do two things before tomorrow’s appointment: (a) ask Daniel to write me a reference for the voluntary position I was considering applying for and (b) get in touch with Nexus again to organise my second stint of therapy with Paul. Re: (a)…well, I have asked Daniel for the reference, to which he has agreed. However, I’ve not filled in anything of the application form, which therefore renders the request redundant. As for (b)…no chance.

Normally speaking, it seems like an uphill battle (at a bloody 85° slant) to acknowledge the mere existence of others, which both of Christine’s challenges require. I simply can’t face any communication without A holding my hand (literally and metaphorically). Beyond reading, I can’t really do anything off my own bat, and even if I could, I wouldn’t enjoy a milisecond of it. I haven’t had a bath in about a month. I keep trying to rewatch Babylon 5, but I can’t concentrate on it. I’m scared, I’m low, and I’m so, so tired. But I have something to cling to, for now at least.

Anyway, any advice you have on Depakote, Lithium or indeed any other mood stabilisers would be greatly appreciated. Thanks folks.



53 thoughts on “Any Thoughts on Depakote or Lithium? ***¡Advice Please!***

  1. Ok this is going to be silly but I literally saw the title of your post and the sentence where she mentioned Depakote and Lithium and I jumped down to comment before reading everything. I felt that I had to rush and say something. Ok I’ve been on both Lithium and Depakote. Be very careful!

    When I was first diagnosed with bipolar disorder, I was very, very skinny. When I was hospitalized they put me on zyprexa and I gained 30 lbs. I went off of that and went on Lithium. I was thirsty all the time and I gained more weight but I’m not sure how much the Lithium contributed to that. My biggest warning is about Depakote. I gained over 60 lbs on Depakote and my docotr told me that I couldn’t lose the weight through exercise and diet because of what the medication does. It increased my appetite to the point where I was having seconds and thirds and my stomach was still having hunger pains. On top of that it slowed down my metabolism so that I couldn’t burn the calories etc. In the end I had gained over 100 lbs on meds, most of it from Depakote. Did it work as a mood stabilizer? Yes, I think so. But I would rather be in the hospital than ever take that again.

    My doctor eventually replaced the Depakote with Keppra and I was able to lose about 90 lbs. I just had to say something Pan.

    • Gah, I’ll never take Olanzapine/Zyprexa again – I took 2.5mgs when I was first put on an anti-psychotic, and that minimal dose fucked with my weight. I don’t blame you for going off it, but shit – that’s baaaaad about the Depakote 😦 I have no idea if Keppra has made its way to the UK yet or not. *Googles* OK, it has, but I can’t find any info as yet on whether it’s used off-label for mentalness. I’ll ask her.

      Thanks for the heads-up, hun, I appreciate it. xxx

      • No problem. I also noticed that Lamotrigine was mentioned here. I was on that recently and it worked better for my depression than some others. I saw you say that you’ve never been a “proper” manic and I’m the same way. My mania is a lot, of anger and irritability with some highs to it but I’m NOT a happy manic. My bipolar is more depressive.

        Anyway I took Lamotrigine/Lamictal and I wanted to say that we noticed that the company that makes the one you get matters.

        There are at least two companies that make it and only TEVA worked for me. One time the pharmacy gave me the generic from the other company and I couldn’t figure out why my mood got worse. My psychiatrist immidiately asked me what color my pills were and I told him. He said that they had given me Lamotrigine from the other company and that his patients all had trouble with their version of it. He to write out a script specifcally saying to give me Lamotrigine from TEVA so it wouldn’t happen again. Just wanted to throw that out there.

      • ooh that’s interesting, i’ve had both brands (at least i assume i have since the tabs have been different colours/shapes/packaging, and not all have been named “lamictal”) but i’ve not notcied a difference – which is almost certainly because i’m on a fairly low dose (75) and it’s alongside a heftyish dose of lithium so is kind of subsumed by it…

        i’m the same as you btw – my mania is extremely dysphoric. it actually kind of annoys me that all the websites and texts about bp talk about how mania is euphoric and elated and stuff, not for me it ain’t! they really need to start mentioning dysphoric mania more, as people really don’t get it.

      • Lithium has a strong hangover effect for a long time until you get used to it. Weight gain on most these drugs is also partially becasue of their negative effect on your impulse control!

    • oh god i forgot the thirst! actually mine’s not been nearly so bad since i stopped the seroquel a couple years ago. but it’s been REALLY bad in the past. to the point where i had to have 2 root canals and 2 teeth totally removed (and there are a couple more that are definitely on the way out but i’m putting off seeing the dentist) and that was just within 18 months!! and this is the thing – lithium and various antips cause dry mouth and i think as a consumer you often just think “oh well it’ll make me thirsty” and tbh that’s how docs usually put it. but having a mouth that dry is really unhealthy – lack of saliva rots your teeth, kids, and the docs won’t tell you that. plus ever since being on lithium i’ve been totally paranoid about having horrible breath – mainly because since being on it my mouth tastes disgusting to me, and i think that’s another part of the dry mouth – because ultimately saliva is a built in disinfectant.

      so, er, thanks for the reminder 😉

  2. erm, i’ve been on lithium for 11 years, i was on depakote for about 2 years from 03-05. i didn’t do well on depakote but oddly it wasn’t side effects, but a psychological thing, i could taste the pills (and they’re huge) and every time i took it i’d be sick…

    lithium – er, well it works, generally, but the effects are pretty grim. in the short term it’s the usual stuff (i say that because i honestly can’t remember, i was manic when i started it, in hospital, 11 years or so ago!) but long term it’s horrible. it’ll almost certainly kill your thyroid. taking thyroxine is fine (it’s a synthetic hormone so has zero side effects) but it’s a faff and if they don’t spot it you get the effects of hypothyroidism, like weight gain, depression (ha!) etc.

    which is why on lithium you have blood tests about every 2-3 montbs (they changed it to every 6 then back to every 2-3) – partly because lithium can go toxic spontaneously, but they’ll do thyroid levels too. i found in about 05 i got really depressed and tired out of the blue and my psych actually rang me before i had a chance to see him about it and said “blood tests show your thyroid’s gone, come in, we’ll sort it out” and the thyroxine was helping within about 10 days – so at least the tests mean you can be efficient!!

    as for other stuff – well i have all kinds of physical problems – my joints have been fucked for ages, i get bad headaches, my immune system is totally screwed and if there’s a small cold going around, i’ll get the flu, i am always under the weather etc. i’m convinced it’s from lithium. the problem is because it’s so long term they can’t attribute it directly, which i understand but to me it just fits.

    i generally liken it to taking coke or crack or something for 10 years – if someone takes a gram a day of that stuff they’d be really surprised if 10 years later their physical health was great, right? so how can i take a gram a day of this stuff and how can the docs make me take that, and be surprised if my body gets fucked by it? just because the nhs have said it’s ok doesn’t make it pleasant!

    then again i’m on quite a high dose – i’ve been on “maintenance” for about 5 years (ie just ticking over, it’s not necessarily curing anything) but i’m still on 1000mg, which for maintenance is pretty high. i’ve been on 1600mg before.

    so my view on lithium generally is that it does work (at least i guess that’s why i’m sane now) but it fucks you physically (and the latter is basically an unfounded claim, it’s more of a hunch i guess, and your comment about your friend always being ill rings very true!!).

    as for risperidone, i only lasted 2 weeks on it, it made me wet the bed 13 nights in a row. i was 27, it was horrible!!! but as far as i know that’s unusual…

    have they talked about lamotrigine? i believe it’s generally given as the #1 stabiliser over lithium now as lithium is so hardcore – the other thing to note with these two is that mood stabilisers are just that but most have a leaning one way or the other – some stabilise but with an emphasis on acute mania, others on acute depression.

    lithium is primarily to treat acute mania. yes, it’s a mood stabiliser and can be used for that as a maintenance but its initial prescription is generally in times of actue mania as it brings it down. someone with acute depression (even as part of bipolar) will probably have to try something else first, if they’re in a depressed phase.

    lamotrigine however is more for acute depression – it’s also a mood stabiliser and used for that but it tends to be given initially in acute depressions, as it can bring them up.

    so if you’re depressed, i would suggest lamotrigine rather than lithium. if you’re manic, the other way around. although that obviously isn’t a given and i’m only a consumer (of both!!), don’t take that as verified medical info! but it’s worth bearing in mind for sure.

    have they talked about lamotrigine?

    • one more thing about constant illness, possible tmi as well, apologies…

      i started getting diarrhea *every* time i eat in about 02, about a couple of years after starting lithium. it’s never gone away, i’ve had all kinds of tests including 2 colonoscopies, intolerance exclusion diets, nothing’s been found, or made any difference, it’s just *there*. i’m immune to imodium (when you take it every day it does naff all), so i’ve been taking codeine every day for about 8 years which i’m sure is doing me the world of good 😐

      my joints and muscles are screwed, i’ve had xrays and stuff, nada. ditto about my immunity. i’m *convinced* it’s years of lithium/antipsychotics, and a few doctors have – off the record – agreed, but there’s very little they can do, it can’t be proven, and even coming off lithium is (a) difficult and (b) may not help.

      it’s extremely fucking frustrating!!

      • Crikey. Where to begin?!

        my joints have been fucked for ages, i get bad headaches, my immune system is totally screwed and if there’s a small cold going around, i’ll get the flu, i am always under the weather etc…

        i started getting diarrhea *every* time i eat in about 02, about a couple of years after starting lithium.

        OK, I think all this rules it right fucking out. I have very severe alternating IBS as it is, and am already physically screwed re: things very similar to all you’ve mentioned here. If there’s even a chance that Lithium would make any of it worse, I suspect it’s not for me.

        I was waiting for her to mention Lamotrigine in the appointment, but if memory serves me, she didn’t. I thought this odd as, even though I have a differential diagnosis of bipolar II, my symptoms are way more depressive than manic. I don’t think I’ve ever had a ‘proper’ manic episode (and therefore can’t and don’t have bipolar I), but even episodes of hypomania are uncommon (though I used to experience what I believe were mixed episodes a lot – as far as I know, that’s does get classified as bipolar I, but I think the relevant DSM-V steering group are revising this). So as a first line treatment, Lithium seemed like an odd choice.

        I’ll ask Christine about Lamotrigine tomorrow, and NewVCB at the next appointment. Has anyone any ideas about how it behaves vis a vis weight gain?

        This is all such a pain in the arse because I need mood stabilisation, anti-depressants and anti-psychotics. NewVCB fully intends to continue to keep me on the 300mg of Venlafaxine, but the rest of it is all a bloody blur at the minute.

        Thanks Harrie – I really appreciate this information!

        Take care xxx

      • Just read the Wikipedia article on Lamotrigine’s side effects. It doesn’t list weight gain…but it does cite weight loss as a possibility.

        I could live with the life threatening rash and shit in that case 😉

  3. No experience of lithium or depakote I’m afraid other than friends of friends type stories which I suspect wouldn’t be much help. As for risperidone, I gained shed loads of weight on that. The problem is that a lot of (most?) psychiatric medications have weight gain as a side effect and just because it happened to one person, doesn’t mean it will necessarily happen to you, although it could. All of which is no help whatsoever. I had an ex who took lamotrigine as a mood stabiliser for bipolar disorder and it made a real difference to his life with no adverse effects. Sorry it’s still so rubbish at the moment.

    • the only one where it’s about guaranteed is olanzapine – i’ve been in several hospitals where every patient (near enough) was on that stuff and every single one of them gained – i gained 5 stone in 5 months on it. it was awful!

      most antips do have weight gain effects. seroquel is a bit different as it tends to not make you gain but instead makes it nigh on impossible to lose!!

    • Yeah, I hate that they fluctuate between people so much. I figured I’d ask anyway, as unfortunately my metabolism is a bit of a cunt anyway, so if weight is a common known side effect, whether a common one or not, I’m willing to bet I’d be affected by that 😦

      Olanzapine was completely evil, and I was on the smallest possible dose. Never again. My issue with Seroquel, I think, has not been that it has made me gain weight in itself, but it’s vastly increased my appetite for shit, especially chocolate about which I really didn’t care before I took 600mg daily.

      It’s odd – at 400mg and below, everything side-effects-wise was mostly fine (bar a mild hangover each morning). At 600mg, it all changed 😦

      Thanks both – Harrie, will respond to your other comments in two ticks…


      • when i came off seroquel i was on 900mg/day – which is waaaay high (i believe the official max dose is between 750-900). when i came off it i lost 3 stone in 6 weeks – 2 months without even trying. it was amazing!! (have regained 80% of it but hey ho, i just like eating)

        i had a hypomania after coming off (altho i’ve since read a book about the evils of psych meds and i now think it was actually withdrawal, not relapse – as this book explained one biiiig problem with these drugs is that for most, and especially antips and lithium, withdrawal symptoms are very similar to the symptoms of the illness so the docs’ first reaction will be “shit! relapse! get back on the meds!” and so the cycle begins again….) – anyway, they were like “shit! get back on the meds!” and i was adamant i didn’t want to be back on that shit so i was very reluctant.

        anyway they put me back on 50mg. it knocked me out cold for three hours – that was fucking scary, i’d been *driving* on 900mg…. talk about a wake up call!

  4. Hugs to you Pan. Sounds like an absolute nightmare. There are so many pros & cons with meds & I hope you get it sorted soon. I know how you feel about the weight issue- its a battle I know Im tired of fighting.
    Keep going with the book. Creativity needs to be expressed and can be therapeutic. I started drawing again in response to some of the things coming up in therapy sessions and its re-released my creativity, so go for it. We cant wait to read it:)
    Take care ❤ xxx

    • Thanks hun, it does suck. Hoping you’ll find something that works for you too – and sooner, rather than later.

      So pleased to hear you’ve taken up drawing again – that’s wonderful! I completely agree about creativity being therapeutic. I am still cynical about art therapy and suchlike as monotherapy, but I can completely see how it’d be very advantageous in conjunction with more mainstream techniques. For now, I’ll keep going with The Book, but one of these days I may try and draw a bit more myself. Good for you!

      Take care xxx

      • Hey missus you can take some credit too:) I like the way you have all the words in different colours etc. at the top of your page. I use words in my stuff too because obviously they mean a lot personally and explain what youve been through. At the beginning maybe it was me just working through some thoughts(Im very visual) but now I think its more about me- the person I used to be – I did art for my degree. Its all a journey and that part of me had disappeared but is re-emerging with a vengeance.
        Take care. Glad u r gettin so much advice here xxx

  5. I swapped from Seroquel to Seroquel XL to Lithium (I think I’m quite sensitive to anti-psychotic side effects, so the Seroquel was awful). The lithium made me a bit foggy to begin with, then as I went up the dosages I’ve noticed a mild tremor but the fogginess has gone. I haven’t gained weight (but I didn’t gain weight on seroquel either). I don’t know how much it’s helped moodwise, since I’ve been down, but I have been getting rapidly better with adjunct sertraline. I totally prefer Lithium to Seroquel.

    My mother and boyfriend take depakote, and they seemed to get more side effects than I’ve had with lithium. Mum gets all the gastrointestinal issues and she’s put on a lot of weight. My boyfriend had some nausea. I think it’s helped mum (until they reduced her dose, then she crashed and they raised it again) and my boyfriend says he feels more stable (although he got down enough to be put on mirtazapine).

    I think these drugs need to be taken with anti-depressants, as the research implies they are more effective against mania than depression. I would reccomend Lamotrigine, as that started to make me feel a better in a week, but then I got the dreaded rash and I’m not allowed to try it again, and research implies it’s more effective against depression than the other mood-stabilising drugs. Slowest titration possible.

    (I’m sure you know all this already. *faceplants desk*)

    I like Lithium and I think I’d have liked Lamotrigine too if I’d had a proper chance. There.

  6. Ooooh depakote… I hated the stuff. But that is almost entirely because they smell exactly like medicated mini eggs and made me gag. Which sucked because I was taking three doses of two pills each day. Also, they’re huge. Like horse pills. They had very few side effects for me, the main one being that although they didn’t make me gain weight, they made it impossible to lose.

    Whether or not they actually worked, I have no idea.

    Never tried lithium.

    Antipsychotics have been rather better. Aripiprazole, notably. It was horrific for the first three weeks, but sooooo worth getting through. It stabilised me wonderfully. The only problem is that either it stopped working or I got worse. So on to risperidone, which is ok. If I miss a couple of doses I apparently wind up thinking dragons are trying to kill me.

    Olanzapine works the best for me in terms of mental health. But it made me fat and sleepy.

    Hope you find something that works for you without the side effects as soon as possible xx

    • i was glad to read this as i thought i was the only one that had reacted so badly to depakote’s size and smell! and they taste like they smell too. just vile! i had to come off them as i was being sick after every dose 😦

  7. Hi Pan

    I’ve been on both, was allergic to actual Depakote so took Sodium Valproate for ages- same thing, different colour. I probably shouldn’t even comment as my hatred of all psychtropic medications is well-known but if you look on my blog you’ll see plenty about Lithium.

    hth, sorry you’re having a hard time.


  8. Lamictal + AD works well for some people, so I have heard. 😉 Some People get a lot of deja vous and jamais vous though. And titration to the right level is an utter pain in the arse. So I have heard.

    And weight gain is certainly not a side effect 😉

    There is also Topiramate (sp?) Not sure what it’s like as a mood stabiliser, I think it’s another anti-convulsion with off label uses, and I don’t think it has the mood boosting properties of Lamictal, but it’s well known for it’s weight loss properties. It is supposed to make you a bit thick though, but again, it just depends on the person.


  9. My partner’s been on Epilim (sodium valproate – almost the same thing as Depakote, which is semisodium valproate) for bipolar II for a few years now. She’s not certain whether it’s affected her weight/appetite or not. She thinks it might be making it more difficult for her to lose weight, but she hasn’t noticed any dramatic difference in either her weight or appetite since she started taking it. Incidentally her psychiatrist was VERY reluctant to prescribe it to a woman of child-bearing age until she pointed out that she’s in a lesbian relationship and hardly likely to get pregnant accidentally!

    She also takes lamotrigine and gets no side effects from that. Definitely worth asking about, as apart from The Rash I don’t think it causes many issues, and it is supposed to be good for depression.

    Hope that helps – I’ve never tried mood stabilisers and neither of us has any experience with lithium.

    I hope you feel better soon! Glad you have your writing at least. It’s good to hear about that. 🙂 Don’t beat yourself up, OK? And I hope Christine is helpful tomorrow. xxx

  10. Hi, I’ve been on both lithium and depakote. For me lithium did not work well and during a depressive episode I took a large od and ended up on dialysis for a while. Gained 5 stone in 2 years whilst taking it but was so mental I didn’t really care at the time. Weight dropped off quite quickly when I stopped. Hated depakote, no one else has mentioned it but it can give you horrific acne, my face and back were like a pizza and they scarred even though I never had any problem with my skin as a teenager. I’m now taking lamotrigine and have to say that it is the best out of all of them. Good luck, hope things get better soon.

  11. Hi Pan. Depakote i got an allergic rash so had to stop taking it. Seroquel, arirpiprizol etc all gave me weight gain and other side effects so i knocked them on the head pretty quickly too. now i am on Lamotragine which has not caused weight gain and Topiramate which up til now has not caused weight loss either but i have just swapped from the capsules to the tablets as they are easier to take. Lithium has never been suggested but i do know people who take it and I think it sounds pretty scary to me but i guess if it works then sometimes thats what you need. I’m not the best at taking drugs, if i don’t like the side effects then i find myself dropping my meds which has meant over time i have tried quite a few it also means that even if they make me feel better initially as i feel better then i get to the point where the side effects are worse than the way i feel. Frustrating but it has meant that i have got to a compromise of sorts where my meds aren’t perfect but i can function on them and live with the side effects most of the time.

  12. I took lithium for about 3 years. The main thing I remember about it was the bad stomach it used to give me. I would get a two minute warning and would have to rush to the loo. I gained alot of weight as well which I have found difficult to lose. The blood tests are also a pain. I believe it is best avoided if at all possible. Hope this helps !

  13. Everyone reacts differently to different drugs – like it or not, it’s a unique trial and error experiment every time.

    For the first time in 24 years my body is clean, no psychiatric drugs at all. For the last four years it was just Depakote. At my worse it was mood stabiliser, anti-psychotic, anti-depressant plus sleeping tablets.

    (Remember, weight gain is an association, not a direct result of medication. Drugs may well leave you sat on your arse comforting yourself with food – but it is increased activity, not the lack of drugs, that will get you fit.)

    • i don’t know if that’s true, when i was on olanzapine i gained loads (like size 12-22 in six months) – i was doing the same job, same amount of activity as before, eating the same etc. then when i came off seroquel i lost 3 stone in 6-8 weeks with zero effort, no dieting, no more exercise than usual.

      congrats on getting drug free – how long did it take you? i’m hoping to try it sometime soon….

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  15. I was on Sodium Valproate for a while – similar to Depakote. It did absolutely nothing at all to stabilise my mood.

    I tried Lithium but it was an unmitigated disaster, making me incredibly depressed in a very short space of time. However, that is apparently very rare.

    Lamotrigine is usually weight neutral. I have gained weight since starting it, but as I started another drug at the same time I can’t be sure which drug caused it. Lamotrigine has been completely successful in stabilising my moods and removing depression – so far anyway! It just took a fair while to work as the dose had to be titrated carefully. But by far the most successful medication I’ve ever tried, in addition to having no side effects at all.

  16. My crazy italian psychiatrist once decided that I should try lamotrigine. I’m not bipolar or anything, but it helped with general day-to-day moods quite a bit, and made me lose weight! However when I ended up in hospital my psychiatrist there was a bit ‘wtf’ at the fact I’d been prescribed it, and took me off it.

    Also, I noticed you mentioned Risperidone – I gained three stone on that stuff, and it did not help one bit. And I was only on 2mg! I’ve actually gained a little less on olanzapine than I did on risperidone. Also, it can proper mess up your hormones and give you hperprolactinaemia or whatever it’s called…not nice!

    I hope you find something that works without too many horrible side effects.

    Sending you lots of hugs, take care Pan xx

  17. Sorry for not replying individually since yesterday afternoon. I’ll try to do so tomorrow. However, thanks to each and every one of you for your thoughts – one and all have been very helpful. I’m not sure yet when my next appointment with NewVCB will be, but I think I’ll be asking her about Lamitrigine rather than the two I initially mentioned: whilst it’s true that different things work for different people, there are too many horror stories for me here about Depakote and Lithium!

    I know NewVCB isn’t very keen on diagnoses, but her behaviour/thoughts re: the drugs is still irking me. If she believes me to have a personality disorder, why is she medicating me at all? (Admittedly she has far more sense than to listen to NICE in a blanket fashion, but you know what I mean). If she thinks I have a form of bipolar disorder, why are we only discussing mood stabilisers now? If she thinks it’s psychotic illness, am I fucked if I reduce the Seroquel?

    I know psychiatric diagnoses are mere guidance signs, rather than fully discreet and enclosed health conditions, but you know me…I like to have nice, telling names for everything.

    Anyway, folks, many thanks to one and all again.

    Take care

    Pan x

    • Mood stabilising drugs are also useful for BPD. Lithium in particular is good at augmenting antidepressants. Lamictal is good, but only really is you’re already stable and for depression. With me though it has turned my brain to slush. I’m mentally fine and stable, but I can’t think straight at all.

      I would advise strongly against Depakote, because is Seroquel bothers you with weight, Depakote is worse. Lithium is okay- I hated it, but I wasn’t getting my bloods drawn regularly enough and thus kept getting toxicity. If you can get regular bloods and are good about it, then it’s a good drug.

  18. I was thinking about the Seroquel.

    I know that for me, in order to control the psychosis and sleep I take 100 mg. If I do more than 200 I’m too sleepy. I do know that if I don’t take something, I WILL hallucinate. The only thing that I’ve taken recently instead of Seroquel was Saphris, which you put under your tongue and it’s absorbed through your mouth not your stomach. It’s not supposed to increase blood sugar like Seroquel or lipids. I didn’t stay on it because I think it didn’t help me sleep if I remember correctly. But, I didn’t have any hallucinations that I can remember either. It tasted awful, even in the black cherry flavor!

  19. I have nothing useful to add to this Pan as i’ve only ever had AD’s (currently venlafaxine which I think is how I found this blog waaaay back!!) But I wanted to thank all the commenters for the info on MS’s cos my sis is oddly enough having a med review next week and they were thinking about lithium so alot of the comments here will bs helpful for her.

    Best wishes

    • Oh and also- sorry Pan- really sorry that things are still bad for you. Its good that you have the Book to distract you but even with that I know how horrible it is and i really hope it passes somehow soon. I hope your appt with Christine was useful.

      Best wishes

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  31. I was on Lithium for a while and am in the process of coming off it. Not because it doesn’t work (to an extent it does stablilise my mood – I’m not bipolar but my mood swings are horrendous, part of my CPTSD with BPD traits diagnosis) but because I’m constantly thirsty and can’t stop putting weight on. Even if I eat tiny amounts of food and do exercises, I put weight on. Some say this is ‘water weight’ due to the increased thirst, but I doubt I’m carrying round a couple of extra stone in water! I’m sure it does work well for some, without side effects like these. But it’s not for me.

  32. Lithium made me hungry, and I did gain about 20 pounds on it. My psychiatrist said that Depakote (as far as she knows) does not make you hungry, but reduces your metabolism. I’m seeing that I’m eating the same on Depakote, yet weight creeps on (from the metabolism issue). I liked Lithium better b/c when I went on a lower carb diet, I lost 60 poundls over the course of 10 months. I fear that on Depakote I will have a harder time losing weightl. It seems that there is much more negative publicity about Depakote than Lithium. I had a regular doctor tell me to be very careful with Depakote, and my psychiatrist got pissed off when I told her what the general practitioner had said. I gained a whole size (I am 5′ 7″, so I am not sure how much weight that is). I am very unhappy with my doctor and will get a second opinion. She would not switch me to anything else, yet claims I am Bipolar II. I don’t understand. The woman is about 70, and I do believe she doesn’t want to be bothered with the so-called newer drugs . I had to switch from Lithium because it can cause kidney problems,, and I was on it for 19 years. Good luck to you. I’m sorry this is so long. I’m pretty down in the dumps today…..

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