Tapering valproic acid

Hey Jef, welcome. Fourteen years on valproate is a long stretch and it's good you're working with your psychiatrist on this rather than going it alone. The 250mg tablet size does make things tricky, but there are ways people handle it, like splitting tablets or talking to your pharmacist about liquid options or compounding.

Thanks staff for your reply .I haven’t seen the psychiatrist yet but need to contact him. I was considering requesting a medication review from 1000mg to 750mg a day valproic acid and stay on that dose for a while . I would like to reduce it to 250mg morning but remain on 500mg in the evening . How would I reduce dose from 500mg to 250mg in the morning ? What is the liquid formulation and how many/weeks is suggested for lowering the dose in two steps ?

I think you dropped a zero in there in the first sentence. That's an important difference. About my experiences and those of my friends' with valproic acid: No idea what is the safe amount to cold turkey. No idea or confirmation how any of it really works. The withdrawal appears to be less of a serious one than that of antidepressants. I had a very bad experience with the form of sprinkles. Not sure what happened.

You probably, should check whether Extended Release can be cut, split or filed if you want to do that. You should pay attention what form you are using, exactly, if it is Extended Release or Immediate Release.

Hi Jef, I've been on valproic acid, off and on for at least 30 years. My most recent stretch with it was probably about 3 to 5 years. The last few years I've been hospitalized several times and they keep increasing my dose to about a 1000 mg. Each time after I got home, I tried to reduce it or go off of it completely with a stepwise reduction cutting pills, to the equivalent of about a 125 mg reductions Every 6, 8 or 12 weeks. This was not a good method. I would not recommend it. The most pronounced withdrawal effect was insomnia, which exacerbated my psychotic disorder, got me rehospitalized and caused them to increase the dosage once again, thereby, undermining my goal of getting off the medication. I would recommend looking at the tapering advice on this forum, which describes information about the medication. (There is a tab in the mood stabilizers/depakote/valproic acid forum - I can't remember quite how to get there because I'm new here.) It has great info, including the fact that valproic acid comes in an oral liquid and sprinkle capsules. If you get your prescriber to prescribe one of those, you can easily titrate the dosage in small decrements, decreasing it by very small amounts and percentages, as you go. One thing to consider and be cautious about Is that you cannot split or crush extended-release or delayed release tablets. That can cause very serious medical effects, because it releases too much of the drug into your bloodstream at once. I have tried it myself, disregarding the advice, and could actually feel it making me feel slow in my brain/mind, almost as though it had caused some brain damage, which scared me, but it seemed to be temporary. Still, I don't think the risk is worth it. One other thing I can mention, but I cannot claim to give medical advice, is that in my experience, I have used a supplement called magnesium glycinate to help with my sleep and calm while withdrawing from valproic acid. It affects gaba and ion channels in a similar way, I believe (but I don't think the same way) that valproate does. I would recommend looking this up and researching it, as well as consulting a holistic health psychiatrist or other holistic health practioner. One holistic psychiatrist once told me that magnesium glycinate is becoming popular in holistic circles to use as a mood stabilizer. So it's something to think about and maybe ask a practitioner who is familiar with alternative and holistic therapies. It has helped me lower the depakote, but I still had to do it slowly.

Hi sue thanks for your info on valproic acid . Your comments have been very helpful and insightful . I will look into liquid formulations with my consultant going from 1000mg to 750mg very slowly but not coming off it. What steps did you take to go to 750mg?