Review Of Specific Agents And Their Efficacy And Tolerability In Treatment Of Social Anxiety Disorder
SRIs.
Pharmacologic treatment aims to decrease anticipatory anxiety and avoidance behaviors before, and distress during, essential social activities to improve social and occupational functioning. As with the other anxiety disorders, SRIs are the pharmacologic treatment of choice for generalized social anxiety disorder. Performance-only social anxiety disorder is generally not treated with maintenance medications because most people infrequently encounter the feared performance situations. The drugs in these classes that carry the FDA indication for social anxiety disorder include the SSRIs sertraline, paroxetine, and paroxetine CR as well as the SNRI venlafaxine XR. Data from RCTs also support the use of the SSRIs fluvoxamine, citalopram, and escitalopram . Some initial data support SNRI duloxetine for the treatment of social anxiety disorder . Fluoxetine has less consistent evidence . Escitalopram, paroxetine, sertraline, and venlafaxine were shown in a meta-analysis to have roughly equivalent effect size and superiority to placebo . Principles guiding titration and dosing are similar to those applied to generalized anxiety disorder and panic disorder.
Beta-adrenergic blockers.
BZDs.
Anticonvulsants.
MAOIs.
Miscellaneous medications: other antidepressants, buspirone, and neuroleptics.
What Are Possible Side Effects Of Depakote
Common side effects of Depakote include:
Depakote may interact with ritonavir, phenytoin, carbamazepine, phenobarbital, primidone, aspirin, carbapenem antibiotics, felbamate, rifampin, amitriptyline, nortriptyline, carbamazepine, clonazepam, diazepam, ethosuximide, lamotrigine, tolbutamide, warfarin, zidovudine, lorazepam, and topiramate.
Depakote And Depakote Er And Pregnancy
If youre pregnant or plan to become pregnant, your doctor will likely recommend that you dont take Depakote or Depakote ER. They will usually recommend a different treatment option for your condition.People who are pregnant or could become pregnant should not take Depakote or Depakote ER unless other medications are unsuitable.
Depakote and Depakote ER have a boxed warning regarding the risk of fetal harm during pregnancy. A boxed warning is the most serious warning from the Food and Drug administration .
If taken during pregnancy,Depakote and Depakote ER can cause serious developmental problems in a fetus. This can include neural tube abnormalities , such as spina bifida. Other issues can include hearing problems, and physical abnormality of the head, heart, or limbs.
In addition, taking either drug during pregnancy may cause children to have other developmental conditions. They may also have an increased risk of autism spectrum disorder.
If you become pregnant while taking Depakote or Depakote ER, talk with your doctor right away. They can discuss the risks and benefits of continuing treatment with this medication. They may also recommend a different treatment option for your condition.
Pregnancy registry
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Depakote Lamictal Topomax Xanax Klonopin
Hello,
My name is Steve, and I’ve had three seizures in the past year. I was seizure free my entire childhood, but had my first grand mal while serving in Afghanistan in Spring 2007. My next seizure was in August of ’07, and my last one was on January 19th of 2008. I am also diagnosed with having bipolar disorder.
I am currently taking 100mg of Lamictal, and 1500mg of Depakote, along with 2mg of Xanx and 10mg of Zolpidem per day. The doctors are trying to ween me off of Lamictal, but that’s where the problems started.
Depakote gives me out of body experiences, and makes me feel like I’m going to black out. Needless to say, this causes major anxiety, and forces me to think that I’m about to seize. That causes me to take Xanax, which puts me to sleep. I can’t continue to work like this.
Lamictal never caused many problems, but I did have a seizure while I was on it. Should I just raise the dosage of Lamictal, move on to Topomax, or what? I’m definately done with Depakote, and I need to move on to something longer-acting for my anxiety. Xanax is too powerful but too short acting for me. Plus, it causes severe drowsiness when I need to be awake most – at work.
My employer has recently demanded a letter from my neurologist, explaining my disorder and explaining why I am always appearing “out of it” or “drowsy”. It’s like they want to find a way to fire me. I can’t live without working, so I have to get this medication working. SOMEBODY PLEASE HELP!!!!
No Easy Solutions But Improvement Is Usually Possible
As many of you know, behavior problems are difficult in dementia in large part because there is usually no easy way to fix them.
Many probably too many older adults with Alzheimers and other dementias are being medicated for their behavior problems.
If your family is struggling with behavior problems, I know that reading this article will not quickly solve them.
But I hope this information will enable you to make more informed decisions. This way youll help ensure that any medications are used thoughtfully, in the lowest doses necessary, and in combination with non-drug dementia behavior management approaches.
To learn about non-drug management approaches, I recommend this article: 7 Steps to Managing Difficult Dementia Behaviors
And if you are looking for a memory care facility, try to find out how many of their residents are being medicated for behavior. For people with Alzheimers and other dementias, its best to be cared for by people who dont turn first to chemical restraints such as antipsychotics and benzodiazepines.
This article was first published in 2016, and was last updated by Dr. K in May 2022.
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Dosage For Prevention Of Migraine
Depakote delayed-release tablets and Depakote ER tablets are approved to help prevent migraine in adults.
For Depakote delayed-release tablets, the usual starting dosage is 250 mg taken twice per day. If needed, your doctor may increase your dose up to 1,000 mg per day. Your doctor will advise you on what dose to take and how often.
For Depakote ER tablets, the typical starting dosage is 500 mg taken once per day for a week. If needed, your doctor may then increase your dosage up to 1,000 mg once per day.
Depakote delayed-release sprinkle capsules are not approved to help prevent migraine.
Do Depakote Or Depakote Er Come In A Liquid Form To Be Given By Iv
Depakote and Depakote ER only come as medications that you take by mouth.
A similar medication, valproate sodium, comes as a solution for intravenous infusions . This drug is only used to treat certain seizures. It isnt used to treat mania related to bipolar disorder or prevent migraine.
If youre interested in hearing more about valproate sodium, talk with your doctor.
The dosage of Depakote or Depakote ER youre prescribed may depend on several factors. These include:
- the type and severity of the condition youre using Depakote or Depakote ER to treat
- the form of Depakote or Depakote ER youre using
- whether youre having side effects from taking either drug
- other medications youre taking
- other conditions you may have
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Depakote And Depakote Er And Lab Tests
Depakote and Depakote ER may affect the results of certain lab tests. These include:
You should always take Depakote and Depakote ER according to your doctors instructions.
Depakote and Depakote ER come in these forms:
Depakote delayed-release tablets. These tablets have a special coating that stops them being broken down by your stomach acid. The medication is released after the tablet has passed through your stomach. Theyre usually taken two or three times per day.
Depakote delayed-release sprinkle capsules. The sprinkle capsules contain pellets that have a special delayed-release coating. This stops them being broken down by your stomach acid. The medication is released after the pellets have passed through your stomach.
The sprinkle capsules can be swallowed whole. If you have trouble swallowing tablets or capsules, Depakote delayed-release sprinkle capsules may be a good option for you. You can open the capsules and sprinkle their contents on soft food. Theyre usually taken two or three times per day.
Depakote ER tablets. The extended-release tablets release the medication slowly into your body over 24 hours. Youll only need to take them once per day.
Depakote And Depakote Er For The Treatment Of Certain Types Of Seizures
Depakote delayed-release tablets, Depakote delayed-release sprinkle capsules, and Depakote ER tablets are FDA-approved to treat certain types of seizures that occur with epilepsy:
- complex partial seizures
- simple and complex absence seizures
For this use, Depakote and Depakote ER may be used alone or in combination with other seizure medications. The drugs are approved for use in adults and children ages 10 years and older.
Complex partial seizures and absence seizures may occur on their own or with other types of seizures.
Note: Depakote and Depakote ER have some limitations of use. These drugs can cause fetal harm. People with bipolar disorder who are pregnant or could become pregnant should not take Depakote or Depakote ER unless other medications are unsuitable. For more information, see the Depakote and Depakote ER and pregnancy section below.
Depakote and Depakote ER have a for this side effect. A boxed warning is the most serious warning from the FDA.
About epilepsy and complex partial seizures
Epilepsy is a condition that causes repeated seizures due to excessive electrical activity in certain parts of your brain. The type of seizure depends on the part of the brain thats affected.
Symptoms of complex partial seizures may include:
With a complex partial seizure, youre typically unaware of the seizure or your surroundings and unable to respond to others. After the seizure, you may be confused or sleepy, and you may not remember the seizure.
- staring blankly
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Alternatives To Depakote And Depakote Er
Other drugs are available that can treat your condition. Some may be a better fit for you than others. If youre interested in finding an alternative to Depakote and Depakote ER, talk with your doctor. They can tell you about other medications that may work well for you.
Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label drug use is when a drug approved by the Food and Drug Administration is used for a purpose other than its approved use.
What If I Want To Stop Taking Mood Stabilisers
Do not stop taking your mood stabiliser without first talking to your doctor. If you need to stop, your doctor can reduce the dose slowly over a few weeks. You should look out for signs of your illness returning if you are stopping your medication.
You may get withdrawal symptoms if you stop taking your medication suddenly. These symptoms depend on the medication you are taking. Talk to your doctor about withdrawal symptoms before stopping your medication.
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Depakote And Depakote Er Use With Other Drugs
Depakote and Depakote ER are sometimes used with other drugs.
Epilepsy. If you have epilepsy, your doctor may prescribe Depakote or Depakote ER with other anticonvulsant drugs to help control your seizures. Examples of other anticonvulsant drugs include:
- sumatriptan and naproxen
Talk with your doctor or pharmacist if you have questions about taking other drugs with Depakote or Depakote ER.
Here are answers to some frequently asked questions about Depakote and Depakote ER.
Placebo Controlled Trial Of Depakote Er In Alcohol Dependent Patients With Mood And/or Anxiety Symptoms
| The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. |
| First Posted : September 20, 2005Last Update Posted : October 8, 2009 |
| AlcoholismAlcohol Related DisordersMood Disorders | Drug: divalproex sodium extended release | Phase 2Phase 3 |
This randomized, double-blind clinical trial will examine the effectiveness of extended release DVP in the treatment of co-morbid mood and anxiety disturbance in alcohol dependent subjects. The primary hypothesis is that subjects treated with Depakote-ER will have significantly lower scores on the Symptom Checklist than will placebo treated subjects over the course of the study. Secondary hypotheses include: 1) Compared to placebo treated subjects, subjects treated with Depakote-ER will demonstrate significantly lower scores on additional measures of depression, anxiety, and irritability, 2) will have fewer alcohol use days and fewer drinks per drinking day, and 3) will evidence better retention in alcohol dependence treatment.
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Rational Pharmacologic Approach To Generalized Anxiety Disorder
Comprehensive, evidence-based guides to direct treatment of generalized anxiety disorder are limited, with one noteworthy exception being the Canadian Clinical Practice Guidelines for the Management of Anxiety, Posttraumatic Stress and Obsessive-Compulsive Disorders . In this sizeable review, the authors stratified treatment interventions according to established efficacy, quality of evidence, and tolerability and safety considerations furthermore, they proposed a hierarchy of first-, second-, and third-line monotherapy options as well as ranked adjunctive treatment options. The authors concluded that SSRIs and SNRIs along with pregabalin should be considered first-line treatments. They characterized TCAs, BZDs, vortioxetine, bupropion XL, buspirone, quetiapine, and hydroxyzine as second-line treatments. They qualified miscellaneous antidepressants and valproic acid in rare formulations as third-line treatments. Finally, for adjunctive treatment, they favored pregabalin over second-generation antipsychotics .
FIGURE 1. Generic example of a network grapha
Fourth line: Augmentation with other second-generation antipsychotics and use of the miscellaneous antidepressants fall into this category because of limited supportive data and significant adverse effects.
How Long Do People Generally Take Depakote
Before you start taking Depakote , you may have some questions about how long youll need to take this medication. The length of time you need to take Depakote will depend on your diagnosis and specific symptoms. Your provider may prescribe this medication for many yearseven after your condition is under control.
Your Brightside provider will work with you to determine what course of treatment is best for your specific needs. Most importantly, we recommend that you keep taking your medication until your provider says its time to stopeven after you start to feel better.
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Does Depakote Help With Anxiety
Yes, Depakote can help with anxiety.
Depakote works by increasing the amount of gamma-aminobutyric acid in the brain.
This is the brains main inhibitory neurotransmitter, which means that it reduces the firing of neurons.
When receptors for GABA are activated by Depakote, neurons are quieter and thus elicit a calming or sedative effect in the patient.
Introduction Depakote For Anxiety Review
Depakote for anxiety review Depakote is a medication that is used to treat seizures, migraines, and bipolar disorder. It is a type of anticonvulsant that works by stabilizing electrical activity in the brain. This can help to prevent seizures and migraines, as well as to alleviate the symptoms of bipolar disorder. Depakote is available in both pill and sprinkle form, and it is typically taken two to three times per day.
The most common side effects of Depakote include drowsiness, dizziness, headache, and nausea. More serious side effects may include liver damage, pancreatitis, and bleeding. If you experience any of these side effects, it is important to speak with your doctor. Depakote can be an effective treatment for seizures, migraines, and bipolar disorder, but it is important to use it as directed in order to avoid any potentially harmful side effects.
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Should I Use Depakote For Anxiety
Prescription medications marketed under the trade names Depakote and Depakote ER are one of the best available for treating various health conditions. The Food and Drug Administration has granted approval for their use in the treatment of bipolar illness, epilepsy, and migraine headaches.
But should you use Depakote for Anxiety? This article will go into details about the drug, side effects, and standard practices, read on for all you need to know before starting treatment on this medication.
Will Depakote Or Depakote Er Make You Feel High
No, taking Depakote or Depakote ER shouldnt make you feel high.
Feeling high is a term used to describe feeling elated, excited, or full of energy. It can also be a symptom of a bipolar disorder manic episode, which Depakote and Depakote ER are used to treat. The drugs calm the overactivity in the brain that causes manic episodes, so they help relieve this symptom.
If youd like to learn more about possible side effects of Depakote or Depakote ER, talk with your doctor. You can also refer to the Depakote and Depakote ER side effects section above.
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Does Alcohol Affect My Mood Stabiliser
Alcohol is not recommended when using some mood stabilisers.
Drinking alcohol whilst taking valproate can increase your risk of liver damage. And drinking alcohol whilst taking lamotrigine can affect your ability to perform skilled tasks, such as driving.
Your doctor should talk to you about how alcohol may affect your medication.
Will I Need To Use This Drug Long Term
It depends. Depakote and Depakote ER are meant to be used as long-term treatments for certain types of seizures and to help prevent migraine. If you take either drug for one of these conditions and your doctor determines that its safe and effective for you, youll likely take the medication long term.
Your doctor may prescribe Depakote or Depakote ER as a short-term treatment. Theyll usually do this if you are taking either drug to treat a manic or mixed episode related to bipolar disorder. After your symptoms ease, your doctor may switch you to a different medication for long-term treatment.
If you have questions about taking Depakote or Depakote ER long term for your condition, talk with your doctor or pharmacist.
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