Lithium+Valproate combination in bipolar disorder
I've seen a lot of psychiatrists in my neck of the woods prescribe lithium AND valproic acid to bipolar patients - usually in lower doses (i.e 600-900mg Lithium and 1g Depakote for a 160 pound male patient), which doesn't make a lot of sense to me - I'd rather just prescribe one in a higher dose and follow it up with serum concentration tests.
Having said that, are there situations where it is recommended to associate Lithium and Valproic Acid, instead of focusing on third of fourth line...
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Source: Student Doctor Network - July 2, 2023 Category: Universities & Medical Training Authors: FrancisTheCatatonic Tags: Psychiatry Source Type: forums
*~*~*~*2023-2024 Med School Applicant Sticky (PS, AMCAS, Secondaries, Interviews, etc)*~*~*~*
Best of luck, all. 💕the mod squad
Link to the 2022-2023 Applicant Sticky
Link to the Compilation of Essential SDN Knowledge (updated 2019)
Personal Statement
2023-2024 Personal Statement Guide and Reader List
Depakote's Personal Statement Guide/Tips (2008)
Alejandro's Advice on Personal Statements (2015)
Primary Application
...
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Source: Student Doctor Network - May 24, 2023 Category: Universities & Medical Training Authors: chilly_md Tags: Pre-Medical (MD) Source Type: forums
Official Pre-Dental Personal Statement Reader List 2023-2024
NOTE: THIS IS FOR PRE-DENTS! Pre-med students, we will not be able to help you out much!
Hey guys! Time for a new thread 🙂
Here are some helpful links in regards to writing your PS:
**The Official Personal Statement Guide and PS Readers List **
To Premeds: General Advice on Personal Statements
Depakote's Personal Statement Guide/Tips
Just a few notes:
It may be helpful for you to include a bit of a background (ECs especially), so the reader...
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Source: Student Doctor Network - May 16, 2023 Category: Universities & Medical Training Authors: artist2022 Tags: Pre-Dental Source Type: forums
Bipolar 1 Mania - Refusing Depakote and lithium, maxed on Zyprexa, thoughts?
I have a 60 something male with history of bipolar 1 disorder. Started on Zyprexa when they came in, is now sleeping and not receiving PRNs anymore. However, still very grandiose (knows several famous people, is writing a new Bible) and paranoid that his family is conspiring against him. Remains pressured and tangential. They are voluntary and up to 20 mg of Zyprexa, but refusing Depakote or lithium. Started Lamictal as they tolerated in the past but I know its not going to be as helpful for...
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Source: Student Doctor Network - February 10, 2023 Category: Universities & Medical Training Authors: FI-Prexa Tags: Psychiatry Source Type: forums
Confused about Lithium vs Depakote in Bipolar
My understanding is that both medications work better in acute mania than bipolar depression. However CANMAT seems to indicate good efficacy of both in bipolar depression. Though I've heard that VPA is better for mixed episodes. All things being equal how do you weigh starting Li vs VPA in a patient with no contraindications for either. Do you choose one over another based on presenting symptoms? (Source: Student Doctor Network)
Source: Student Doctor Network - April 22, 2022 Category: Universities & Medical Training Authors: yanks26dmb Tags: Psychiatry Source Type: forums
Liver Failure (Depakote) Medical Malpractice Lawsuit
Link to case here: Liver Failure [Medication-Induced]
This case has an expert witness opinion from a GI doc.
Patient was started on Depakote, LFTs were initially fine.
Within 5 weeks she had a liver transplant.
The expert notes that she had positive ASMA and ANA titers and homozygous positive for H63D hemochromatosis. Do these results suggest that there may be an alternative cause for her liver failure? (Source: Student Doctor Network)
Source: Student Doctor Network - November 26, 2021 Category: Universities & Medical Training Authors: bbc586 Tags: Gastroenterology Source Type: forums
Treatment resistant psychosis
Wanting some additional thoughts/critique of my thought process.
Male 40s schizoaffective, bipolar type
Got dc from long term psych admission (about 9 months) on total 300 Clozaril, Depakote with level low 50s, Lithium barely therapeutic. Briefly out at ALF then admitted for threats driven by continued psychosis. Clozaril slowly ticked up current admission few steps and the level is like 460 ng/ml now. Depakote increased x 2 with previous increase barely moving the needle to upper 50s...
Treatment resistant psychosis (Source: Student Doctor Network)
Source: Student Doctor Network - December 20, 2019 Category: Universities & Medical Training Authors: xavier2000 Tags: Psychiatry Source Type: forums
Medical School Comparison Tool for Up to 8 Schools
I made some modifications to existing program comparison tools ( courtesy of @Depakote and @voteknope -- thank you so much, seriously!) to adapt them for my purposes of comparing up to 8 programs in a meaningful, transparent way. If you need help deciding between numerous medical schools, this is the tool for you.
I have included a Sample spreadsheet so you have an idea of what it should look like when you're finished as well as a Template for you to...
Medical School Comparison Tool for Up to 8 Schools (Source: Student Doctor Network)
Source: Student Doctor Network - December 10, 2017 Category: Universities & Medical Training Authors: amerepedestrian Source Type: forums
Depakote
Hi,
I have a patient with Bipolar Dx who is doing beautifully on Depakote. However, she is concerned about her weight gain (she's been taking it for a few months). She is taking 750 mg of the Delayed Release. I would like to taper it off and start her on Lamictal or Topamax. I was wondering generally, how do you guys taper Depakote to discontinue?
I hate taking the medication away as she is doing so well.
Thanks (Source: Student Doctor Network)
Source: Student Doctor Network - September 30, 2017 Category: Universities & Medical Training Authors: ara96 Source Type: forums
What PRN medication would you prescribe for agitation in outpatient setting?
The patient is a young adult with unspecified mental handicap who comes with mom. He has been on the following regimen for years:
clonidine 0.3mg per day
depakote DR 1000mg per day
geodon 200mg per day
valium 20mg per day
(Most of the above medications are split into two dosings a day.)
He has been on the regimen for years and is tolerating medications. Mother does not want to change the treatment. The above combination was from much trial and error and patient used to be much worse....
What PRN medication would you prescribe for agitation in outpatient setting? (Source: Student Doctor Network)
Source: Student Doctor Network - September 29, 2017 Category: Universities & Medical Training Authors: AD04 Source Type: forums
Anti-epileptics instead of benzodiazepines for outpatient etoh wd?
PGY3 here. Recently got a handout from my addiction/substance use rotation. There's actually several regimens it lists here as appropriate for outpatient etoh wd. It states benzos are 1st line, but if there are concerns for CNS depression due to concurrent opioid use, it also has regimens that use exclusively tegretol, depakote, or gabapentin.
Has anyone used those anti epileptics in lieu of benzos for outpatient mild-moderate etoh wd? And what has your experience been like?
Thanks! (Source: Student Doctor Network)
Source: Student Doctor Network - July 16, 2017 Category: Universities & Medical Training Authors: lyla Source Type: forums
Filling foreign rx
I'm a tech at CVS and my PIC is on vacation this week, so we had a floater this weekend. When we opened, an American girl who lives in Europe brought us a script in Russian, which the floater proceeded to fill. Rph took 3 full hours, 180 minutes, editing, translating, entering a FOREIGN physician into our system, and eventually filling. This was for depakote, 300mg. Rph instructed patient to OPEN the 250mg capsules and pour a fraction of the powder into water and drink along with...
Filling foreign rx (Source: Student Doctor Network)
Source: Student Doctor Network - July 7, 2017 Category: Universities & Medical Training Authors: twizzlers713 Source Type: forums
So Lithium or Depakote for Bipolar I?
Ok, so our institution rams down our throats that Lithium >>>>> Depakote. But as I talk to other attendings, they tell me that their residency says Depakote >>>> Lithium.
So I setup a poll and want to know,
1) Your preferred mood stabilizer for acute mania?
2) Your preferred mood stabilizer for maintenance bipolar therapy?
Any good papers/studies to read on Lithium vs. Depakote? (Source: Student Doctor Network)
Source: Student Doctor Network - November 11, 2016 Category: Universities & Medical Training Authors: Blitz2006 Source Type: forums
*~*~*~*Official Personal Statement Guide and Reader List 2013-2014*~*~*~*
This thread is for this year's applicants (for the class of 2018) who are beginning to work on their personal statements. If you're looking for someone to read your PS, check out the list of volunteers below In the most recent post ONLY!!
If you need help getting started, check out the second post in this thread.
If you are willing to volunteer, the thread will be self regulated this year. Respond below, following the instructions at the end of this post (and in the third post), with your credentials and specific things you are willing to edit for (content only, grammar only, etc). Please read the full list ...
Source: Student Doctor Network Forums - February 7, 2013 Category: Universities & Medical Training Authors: Tots Tags: Pre-Medical Allopathic [ MD ] Source Type: forums
