alternatives to Depakote

My son has been diagnosed with organic personality disorder and shizophrenia, paranoid type as a result of a severe brain injury.  He is on risperdal, geodone, lithium and depakote, buspirone, fluoxotine.  The psychotic and personality symptoms are minimized by this combination, but he seems SOOOO tired all the time.   He is also complaining having a much harder time remembering things.  I agree with his observation.  His short term memory does seem appreciably poorer recently.  (The flip side is that his paranoid perseveration has decreased too- Is this a required trade off?) I wondered if there are any possible substitutes for the depakote I could ask the Dr about?  I know it has fatigue as a frequent side effect, and the fatigue definitely worsened when he was put on the Depakote.  The depakote is ordered for probable seizures associated with violent behavior episodes.  He takes 2/3 or his dosage at night.  His depakote level is midrange. I also understand the buspirone has fatigue as a side effect, but his primary dose is at night. Any possible thoughts would be appreciated.  I would hate to think he would be forced to choose between life as a non-paranoid zombie and vitality complicated by uncontrollable violence.

Thank you.

[Roger Gould, M.D.]

There are alternatives to Depakote that may have less lethargy and drowsiness.  Ask your doctor about Topiramate or Gabapentin or Lamotrigine.   All of these medications have side effects and cause some drowsiness, but they vary from person to person so trying another may be the solution you are looking for.

You and your son have a particularly difficult problem to manage.  Ask your doctor to keep trying to find the right mix of medications to balance everything off. It will take time, constant management and periodic change of medications so stay vigilant and keep close contact with the prescribing doctor.