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Bi-Polar Dx and Depakote

Feb 9, 2005

I have been diagnosed Bi-Polar, and taking Depakote 500mg a day. What is the normal dose, and safe maximum dose? What Rx and OTC meds should I avoid? Anything else I should know?

Response from Dr. Horwath

The dose of Depakote can range from 500 mg/day up to as much as 3000 mg/day. Usually the dose is adjusted according to response and adverse effects. Blood levels are also used to help manage the dosage, with therapeutic levels considered to be in the range of 50-100 mcg/ml.

You need to be cautious if you have any history of liver disease (hepatitis, etc.) or pancreatitis. You should not drink alcohol. There have been some reports of an interaction between Depakote and Zidovudine (AZT, ZDV), which may lead to increased levels of zidovudine and symptoms of zidovudine toxicity. You and your doctor should monitor for signs of zidovudine toxicity (severe anemia, etc.).

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