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Mental Health (Expert Forum)
URGENT: Valproic Acid combined with Zoloft
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.
URGENT: Valproic Acid combined with Zoloft
by shelly, Jan 13, 2000 12:00AM
I am 33 years old and have recently been diagnosed as Bipolar 2. I have a family history of mental illness including Bipolar 1 and 2 as well as personality disorders. I have suffered with depression since childhood but only started treatment at about age 20. Over the years I have tried several antidepressants which in the end did not work. I have been to psychotherapy on and off my since age 9 and have been with the same therapist now for about 2 1/2 years whom I see weekly. I have also been on 250 mgs. of Zoloft now for about 1 1/2 years which seemed to take the edge off the symptoms but did not come close to where my therapist or myself wanted. This is where the diagnosis of Bipolar comes in. I was prescribed Valproic acid about 3 months ago which I am taking 1500 mgs. per day divided in 2 doses. My Questions are as follows:
1) Is the combination of these drugs in these doses generally used as a therapy for Bipolar 2 with the emphasis placed on the depression?
2) I have experienced weight gain since the Valproic Acid was added to the Zoloft but previously did not gain weight on the Zoloft alone. I have a history of bulimia nervosa and am having thoughts of stopping this regimen of medication. I have had increased appetite and major sugar cravings but have been doing aerobic exercise daily and controlling my eating but it does not seem to help except for the fact that I have only gained 10 lbs and am still in normal range (5"9 140 lbs) but for me is detrimental to my mental health as I am starting to feel like a beached whale. Why the weight gain? What can I do? Does it affect metabolism? (especially the combination) If so how?
3) I have also learned that 250mgs. of Zoloft per day is a very high dose is this true?
Please help me! I just want to get better so Life feels like worth living but I need to understand my illness more than I do. Sorry for the long post but could not explain any other way.
1) Is the combination of these drugs in these doses generally used as a therapy for Bipolar 2 with the emphasis placed on the depression?
2) I have experienced weight gain since the Valproic Acid was added to the Zoloft but previously did not gain weight on the Zoloft alone. I have a history of bulimia nervosa and am having thoughts of stopping this regimen of medication. I have had increased appetite and major sugar cravings but have been doing aerobic exercise daily and controlling my eating but it does not seem to help except for the fact that I have only gained 10 lbs and am still in normal range (5"9 140 lbs) but for me is detrimental to my mental health as I am starting to feel like a beached whale. Why the weight gain? What can I do? Does it affect metabolism? (especially the combination) If so how?
3) I have also learned that 250mgs. of Zoloft per day is a very high dose is this true?
Please help me! I just want to get better so Life feels like worth living but I need to understand my illness more than I do. Sorry for the long post but could not explain any other way.
Doctor's Answer
by HFHS MD-JM, Jan 13, 2000 12:00AM
Shelly,
First let me remind you that this forum is not intended to handle urgent requests or replace your personal physicians recommendations. Depakote (valproic acid) is a mood stabilizing agent that is used in the treatment of Bipolar disorder and occasionaly bordeline personality disorder. Weight gain is a side effect with Depakote which can for the most part be limited by regular exercise and a healthy diet. The mechanism of action regarding weight gain with Depakote is not clear. Zoloft, an antidepressant used in both unipolar and bipolar depression is genarally prescribed in the 50 mg-200mg range but sometimes higher doses are required and determined on an individual basis.
I strongly encourage that you discuss these concerns further with you treating psychiatrist. Good luck.
Sincerely,
HFHS MD-JM
Keywords: Depakote, Zoloft, Depression, Bipolar disorder
First let me remind you that this forum is not intended to handle urgent requests or replace your personal physicians recommendations. Depakote (valproic acid) is a mood stabilizing agent that is used in the treatment of Bipolar disorder and occasionaly bordeline personality disorder. Weight gain is a side effect with Depakote which can for the most part be limited by regular exercise and a healthy diet. The mechanism of action regarding weight gain with Depakote is not clear. Zoloft, an antidepressant used in both unipolar and bipolar depression is genarally prescribed in the 50 mg-200mg range but sometimes higher doses are required and determined on an individual basis.
I strongly encourage that you discuss these concerns further with you treating psychiatrist. Good luck.
Sincerely,
HFHS MD-JM
Keywords: Depakote, Zoloft, Depression, Bipolar disorder
I, too, am on 1500 mgs of Depakote, 200 mgs of Zoloft and 50 mgs of Lamectal. I have gained considerable weight, I've lost my sexual drive and I'm constantly tired. I, too, feel like a beached manatee. (I'm Bi-Polar and I have been diagnosed with Borderline Personality Disorder. Age: 39, female, professional, single)
I've taken myself off of the above medications several times and each time I've suffered greatly. I've lost friends, jobs, relationships and tried to commit suicide....and for what? A little weight gain and lack of a sex drive. Big Deal. I can live without it.
The good news is that I'm sane again (not that I ever was completely). I have a good job. I'm making new friends, etc, etc.
Please don't take yourself off the medication. It will only make things worse. Believe me.