Epilim (Depakote)
Effects and Side-Effects

When I started taking Epilim (Depakote), I noticed a substantial change. My mood swings stopped and I felt more solid emotionally. However there were problems...

Once the Epilim kicks in, my life becomes smoother. I take the tablets and go about doing the everyday things. My emotions settle down and my cycles stop and and I don't have to pay any attention to them. I don't become overwrought, stress can be handled calmly, and I don't overreact to anything.

I am able to go back to my regular daily schedules, which no longer seem insurmountably difficult or too slow paced and rigid. In fact, I don't need to pay too much attention to being bipolar except to take the medication regularly and marvel at how easy normal people have it.

It is as if the Epilim just calms the waters. No more roiling emotions. No more cycling.

This is very different from Tegretol, which does calm the emotions, but also leaves me unsettled. It is also different from Lithium, which seems to have no effect whatsoever on me.

The last time I started back taking Epilim (I'm no better than anyone else at taking meds consistently), my psych increased my dosage from 400 mg/day to 600 mg/day. It doesn't seem like much, but the difference to me was dramatic.

I started feeling really nauseous, as if I wanted to throw up all the time. The intensity varied, but basically for as long as I was awake the sensation was continuous, night and day.

The nausea became worse about a half-hour after I took the tablets (morning and afternoon) and gradually tapered off to just being bad. And as I got hungry, at lunch time or dinner, the nausea would increase although it was never clear if this was psychological.

I never did throw up, by the way.

This went on for nearly a month. For the first two weeks or so, I didn't mind because I was so desperate to get stable that I would have lived with anything. And in any case, while I was stabilising I was home, so I could cope with the sensations.

However, once I stabilised, the nausea itself began to be a problem. It's really hard to pretend life is back to normal and go back out doing some the regular things if you feel as if you want to throw up all the time.

I knew from the literature that the side-effects of Depakote go away with time, so once I stabilised I kept hoping that the nausea would disappear. By the end of the third week on Epilim, with no abatement of symptoms, I was ready to pack it in and tell my psych to either reduce my dosage or find something else.

But I was scared to do either thing because a lower dosage could mean destabilising in the future and a new medication would mean finding out if would work - a process that would lose me about three to four months of my life as I switched, destabilised, and tried to settle down again.

I had an appointment to see my psych one month after I started taking the Epilim, so I decided to wait until then to tell her about my problems.

In the fourth week, the nausea abated. Thankfully. I can now remain on a medication that works. I am hoping that it has gone away and won't come back. But I have a suspicion that minor changes in medication or my cycles will cause it to recur.

The nausea wasn't the only side-effects of Depakote that I experienced. Along with the nausea came the sensation of acid reflux, as if the upper part of my stomach and my oesophagus was burning. I don't think it was acid reflux in the conventional sense of the term, but the sensation was there.

The third week into taking the Epilim, I got photosensitive. Or maybe I was photosensitive all the time and only emerged into daylight in the third week.

It took less than thirty minutes on one day standing outside for me to get sunburned on my cheeks. They turned a brilliant red and itched. In fact, they did everything but actually peel.

I have brown skin, so thirty minutes is well within my safe limit of about two or more hours of being in the sun. The sensation was so odd that it never occurred to me that I was sunburned until about two days later. I now worry about this and I carry sunblock SPF30 in my car.

I also found out that Epilim and alcohol don't work very well. On one of the days I was nauseous, I had a beer. It was Friday and I was relaxing with friends. However, after drinking half of the beer, I was feeling so ill that I really thought I would throw up right then and there. And I stayed in that condition for the next two hours, feeling very miserable.

I have since sworn off alcohol. It's annoying because at my old 400 mg/day dosage I would drink with no ill effects. Of course, I had had no nausea either. I suppose that now that I don't feel so nauseous, I'll eventually start back drinking socially again. But not in a hurry. I have no desire to feel that way again.

The Epilim also makes me sleepy. Really sleepy. When I first started taking it I would be groggy all the time. But like the nausea it has faded with time.

But I didn't notice it initially. While I was home stabilising, I was drinking about four to five cups of coffee per day. And my sleep pattern was shot to hell, so I didn't notice any grogginess.

Similarly, when I started back work (sorta), I was drinking about four or more cups of coffee a day. Apparently the caffeine cancelled out the sleepiness and I was left feeling more or less normal.

However, I really felt the grogginess the first weekend after I stabilised. I was home, and I usually don't drink coffee on weekends. I got up at nine, staggered around for forty minutes and went back to bed. Got up at twelve, stayed up for half hour and fell back asleep. This went on all weekend.

It scared me because this is such a classic symptom of depression. I thought I had destabilised all over again. It wasn't until Monday at work, when the coffee kicked in that I realised what had happened.

I now drink immense amounts of coffee. One cup with breakfast, as much as I feel like during the day, and one or two cups after dinner. If I don't drink coffee after dinner, I fall asleep within two hours of taking the Epilim.

I get no side effects from coffee. None. I even go to bed when I feel like it and fall right asleep.

I also run an elevated body temperature when I am on Epilim, as if I have the flu. It is quite noticeable. C. likes it because I am a warm cuddly person in bed. When I am not on Epilim, my body temperature returns to normal.

When I last started back up taking Epilim I was quite manic. It pulled me back down within a day, which is a bit quick, but I have tended to be a bit sensitive to drugs. However the Epilim didn't immediately stop the cycling, so I also cycled past normality into a slight depression.

And unfortunately, I got stuck in the mild depression as the Epilim kicked in more strongly. Instead of cycling back up out of depression in about three days, which was the cycle pattern at the time, it took a leisurely two weeks to climb back to normality. That was not fun at all.

That seems the way Epilim works with me - as a relatively fast acting anti-manic and as a slower acting mood stabilizer. The stabilising effect kicks in only after I've taken it for about two to three weeks and it kicks in progressively, so I have to be careful when I start taking the Epilim to prevent it from prolonging my depressions.

The problem with Epilim is that it is too much of a good thing. I last stopped taking it when I was under high stress because I figured it was one more thing in my life and I could do without it. And why the heck not. I was feeling good.

I immediately started my rapid cycling again. It took nearly two-and-a-half months to get my life back in some semblance of order. Worse than that, stopping the Epilim cold worsened my cycle pattern and instead of a 14-20 day cycle pattern, I ended up with a 6 day cycle pattern, which was terrifying.

I started back up the Epilim and kept taking it every day as I should. However, I eventually ran into a final problem which took me quite awhile to figure out. Epilim stabilises me, but it seems to stabilise me at a point were I am not completely functional.

I feel fine, that is, emotionally stable and clear headed. Unfortunately, I was acting as if I were slightly depressed. Everything is hard to do and I have difficulty in completing tasks. It sounds as if it isn't a major problem, but it was and it affected everything I did.

It took me nearly four months to realise that this was happening. During that time I was waiting for the depression to lift or I assumed that I just needed to get my act together. But I just couldn't get my life to function properly.

My psych thinks that I might well have stabilised to normal, but because I have gotten used to being hypomanic I cannot be functional at normal. It's a moot point though - if I'm not functional, then I'm not normal, regardless of what normal means to other people. It could well be that I can only be fully functional when I am slightly hypomanic, but if that's what it takes, then so be it.

I currently don't use Epilim (Depakote) anymore, but it remains in my list of available drugs as a mood stabilizer that may need to be taken with an antidepressant.