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Depakote / valproate / valproic acid for insomnia and irritability?

Wish4TheNight

Wish4TheNight

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Wishbone, how long have you been taking Depakote and has the effect on your sleep remained the same, or has it diminished in time?
 
Wishbone

Wishbone

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Off the top of my head I'd say a couple years and if anything my sleep, especially since switching the dosage around, has improved over time. Don't get me wrong, it's not perfect sleep I get, just much improved on what it was. Five or so years ago I was in a phase where I was waking up every night about six times, not being able to fall asleep for ages etc. I'm far better now. I know I could take any of the antipsychotics and get guaranteed sleep, but the lethargy hangover effect the next day is not something I want, I want to be able to function. Depakote allows the functioning whilst also improving my sleep.
 
Wish4TheNight

Wish4TheNight

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Off the top of my head I'd say a couple years and if anything my sleep, especially since switching the dosage around, has improved over time. Don't get me wrong, it's not perfect sleep I get, just much improved on what it was. Five or so years ago I was in a phase where I was waking up every night about six times, not being able to fall asleep for ages etc. I'm far better now. I know I could take any of the antipsychotics and get guaranteed sleep, but the lethargy hangover effect the next day is not something I want, I want to be able to function. Depakote allows the functioning whilst also improving my sleep.
This sounds really good. I've never had perfect sleep, I always wake up multiple times. The question is: will I fall asleep again? Now, that takes too long. On lithium it was better. It sounds to me like Depakote can have a similar effect.
Thank you again.
 
Wishbone

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Yeah I used to be the same. I'd wake many times but it wasn't just waking for two minutes then sleeping again, it often took ages. I usually wake once per night now, sometimes sleeping right through, and I'm usually right back to sleep again these days too, which means I can really get into those phases of sleep that I never used to.
 
K

keith74

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Keith, your wife could always ask for a slightly higher dose of Depakote rather than adding too many other things? 1000mg isn't all that much (depending on her size etc, of course).
Her typical dose is 750mg but it has been increased to 1000mg during her current mood swings. So she is already on the higher does than usual. I don't think her psychiatrist or my wife will want to increase it again. I don't think it will help much anyway. Given all the things we've tried, I'm pretty sure the bad sleep is tied to her current mood. In the past, as her mood improved, her sleep slowly did also. Hoping for the same again.
 
K

keith74

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Yeah I used to be the same. I'd wake many times but it wasn't just waking for two minutes then sleeping again, it often took ages.
Yeah this is my wife's issue right now. She can initially fall asleep at night. But she often wakes up in the middle of the night. One some days she can fall back asleep in 15-30 minutes. On other nights she simply cannot and has to reach for the benzo.
 
Wishbone

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Does she practice all of the 'sleep hygiene' stuff as well Keith?
 
K

keith74

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Does she practice all of the 'sleep hygiene' stuff as well Keith?
She's tried all the usual things. She has a very healthy diet with no alcohol or caffeine at all. She does 30 minutes of cardio once in the morning (jogging outside) and once in the afternoon (HIIT exercise) before dinner. Goes outside for a 1 hour daily walk. No screentime one hour before sleep. Does relaxing yoga and meditation in the evening. Journaling. Consistent bed time. She has tried melatonin. She sleeps with binaural beats music with sleepphones. Still nothing has stuck enough to give consistent sleep. She still has some base anxiety that she just can't seem to shake despite all the CBT/DBT/meditation/etc that she tries. Any other suggestions are most welcome.
 
Wishbone

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I think you've got most covered! Have you tried a lump hammer? 😄

I assume she's already taking the medication well before bedtime and not just before? I can see a big difference in having the higher dose two hours before. Otherwise I guess it's the unquiet mind of Bipolar.
I would encourage a slightly higher dose. One extra tablet and she may well find the balance she needs. See it as being akin to Lithium in that you need to reach a therapeutic dose otherwise it's just in your system and not being effective. Now, we don't get it monitored in the same way as with Lithium but if you take that as a model to work on then you see one stabilizer that is sure to be at therapeutic dose and therefore should work, and one that only gets to therapeutic dose by increasing/decreasing until happy with it. It sounds to me like she still needs to adjust it to find that balance.
 
K

keith74

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I'm willing to try anything if it will work!

Yeah we've played around with the timing of the doses also. anywhere from 1-2 hours before. Doesn't seem to make much of a difference. Her depakote should be at therapeutic dose. SHe got her blood work done when taking 750mg and her psychiatrist said it came back fine. Now she is at 1000mg. She *is* getting better, that is clear. But it is slow progress. She is at this mild to medium depression that is lingering around with for awhile and, like her unpredictable insomnia, hard to shake.
 
Wish4TheNight

Wish4TheNight

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OK I've had enough now. I contacted my psychiatrist to ask her to prescribe me Depakote.
My mood is all over the place, my head feels weird and heavy like how it feels when I'm in a mixed episode and going towards psychosis. I still can't sleep, I have reached the point where I now take a sleeping pill every night because I won't sleep if I don't and I'll feel wired the next day. Tired but wired, with crazy mood swings.
I need meds. I hope my psychiatrist contacts me today.
 
Wish4TheNight

Wish4TheNight

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Could it be the quetiapine, at this dose, is acting the same as antidepressants with me? Lift the depression but cause a mixed state? This happened to me multiple times with ADs, with two of those episodes even ending in psychosis.
Back then they told me the brief psychotic episodes were part of my personality disorder, in particular the borderline traits.
My current psychiatrist says it's the bipolar because it's during hypomania.
I thought quetiapine was a mood stabiliser and couldn't cause hypomania. I guess I was wrong?!
 
K

keith74

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Could it be the quetiapine, at this dose, is acting the same as antidepressants with me? Lift the depression but cause a mixed state? This happened to me multiple times with ADs, with two of those episodes even ending in psychosis.
Back then they told me the brief psychotic episodes were part of my personality disorder, in particular the borderline traits.
My current psychiatrist says it's the bipolar because it's during hypomania.
I thought quetiapine was a mood stabiliser and couldn't cause hypomania. I guess I was wrong?!
quetiapine does not have the same risk of triggering mania like an antidepressant. It doesn't work that way. If you feel yourself heading towards mania, it is not because of the quetiapine. In any case, it would be good to have a medication to also guard against mania. At 400mg+, quetiapine should also help against mania/psychosis.
 
K

keith74

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Talked to psychiatrist. Will start on 300 mg of Depakote.
That is a pretty low dose so I image you got started on that dose to ramp you up slowly and observe for any side effects. You'll need to get up to at least 750mg before you really get any benefits. Good luck!
 

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