Depakote causes anger?

[Dee]

Dear Doctor:

I've posted in the neurology forum, but in searching questions related to Depakote I came across this forum.  My 6 yr. son was recently diagned with complex partial seizures.  First he was on Tegretol but that produced bursts of anger and incontinence.  Three weeks ago he started Depakote and immediately began loss of bladder control every day, but the worst part was that he became enraged every day and began to act out physically - kicking and hitting me.  His demeanor prior to drug therapy and the sudden onset of seizures was that you couldn't ask for a sweeter child.  How could Depakote cause these symptoms and yet be prescribed for exactly those symptoms?  He's supposed to start Dilantin, but I'm scared of the side effects, especially the gum overgrowth, so I'm carefully considering keeping him off all medication.  I'm just so scared of them, especially after our experience with Depakote.  He was just weaned off this week and had only been on it three weeks.  His personality hasn't returned fully yet.  I just don't know what to do and we're inbetween doctors because of insurance.  Any input is helpful.

Thank You,

Dee

[Kevin Kennedy, Ph.D.]

Dear Dee,

Both of the anticonvulsants your son was prescribed tend to have a relatively low incidence of adverse reactions and have favorable side effect profiles. In the case of Depakote, in the clinical trials leading to its use for treatment of complex partial seizures, more than 1% but less than 5% of the participants in the trials experienced urinary incontinence. And, while aggression was not noted in the clinical trials, it has been reported in case examples or other trials.

Neither aggression nor incontinence would be expected side effects with Dilantin, but there is no assurance of how any one person might respond. Having said that, I would encourage you not to shy away from drug treatment of your son's seizure disorder. It's not unusual to try more than one medication in the search for the drug that will be clinically effective and, at the same time, have a favorable side effect profile for your son.

[Renee Bobian]

Dear Doctor,
My daughter Nicole has a very violent temper.  When she doesn't get her way she get very physical and tries to kill me.  What should I do?

[Patrick Kenny]

Dear Doctor, I am doing a research paper for my psychology class and I want to know what causes anger.  The questions I have are: why do we have anger, is it a good or a bad thing, is it a physiological flaw or a gift?  What triggers anger in the brain, how do we judge when to be mad and when not to?