Question:
After a robust reaction to the antidepressant Serzone, my pdoc put me on
Depakote. As far as I know, he has not changed my diagnosis from
unipolar to bipolar. Depakote is an anti-manic mood stabilizer, and I am
seeing him for depression. Strangely enough, though, my depression is
lifting somewhat and my mood is more even than it has been in two years.
I don't see the pdoc for another three weeks, but I'm wondering: 1) Does the prescription of Depakote always denote a
manic-depressive diagnosis, or is it frequently prescribed for
plain depression as well?
2) How does an anti-manic alleviate depression?
Answer:
The Pdoc is always your best source of information about your
case. A suggestion, you mentioned a robust reaction to serzone, I
take that to mean "strong reaction" The effects of SSRI's such
as serzone take a while to produce a reaction, and likewise
when discontinued their effects continue on for a while
longer. Bipolar is sometimes discovered by the reaction
the person has to anti-depressants......prescribing depakote
I suspect your Pdoc is thinking "possible Bp"
In my experience, Depakote is just a mood stabilizer. It smooths out mania and
also depression in some people. I know that it may indicate
use for only bipolar, but your pdoc may be trying it because you had such a
poor reaction to the Serzone.
If you feel better, don't worry. Unipolar or Bipolar, what matters is that you
have found the right med for you! I'm not sure where you are from, but I happen to know that in Canada doctors
used to prescribe Lithium frequently for unipolar depression. Frankly in my
grandmother's case this seems to have had no success at all. Of course that WAS back in the 70s.
In the medical field, the term "robust" is used to indicate a strong,
appropriate response to a particular treatment. I was wondering if you
meant that Serzone lifted your depression quickly and with appropriate
leveling or if you got semi to high?
Also, I have read about Depakote being used to augment antidepressants in
unipolar depression---particularly the anxious or agitated type. That use
is "off-label" at this point; much the way using the anticonvulsants
Neurontin and Lamacital are. Depakote has been found to alleviate bipolar depression, and, cause it
(!?); but, they prescrbe it for "moodiness" also. This is how many bipolars are dx'ed. ADs tend to trigger latent bipolar. You asked how it works to alleviate depression. Mood stabilizers do
just that - they level out your mood - and can alleviate a depression
OR blunt a mania. Somewhere on the web I recently read a much more
technical description of how this actually works - I think the article
was referring to lithium though - it had to do with glutomate (?)
versus serotonin levels, which people suspect is involved in
depression. (don't ask me to explain.... no expert here!)
Anyway, I find my lithium, another mood stabilizer, does wonders to
lift me from depression. ADs, on the other hand, send me through the
roof. If it works for you - who cares what the diagnosis? (Okay, okay,
we all care... why is that...?). Be thankful you got a quick and
significant response - that's a very good thing and bodes well for you
and your treatment progress. I had the same response to lithium -
worked like a charm.
Depakote, btw, has long been used to treat epilepsy, not just bipolar
disorder.
The Serzone nearly put me through the roof in a few days, not an
appropriate reaction to that antidepressant, which is supposed to be
low-risk in terms of "switching" from depression to (hypo) mania, from
what I understand. My pdoc advised against another antidepressant
because of that incident.
