Even small malfunctions in the activity of the brain sooner or later turn into serious diseases. One of the most unpleasant and dangerous is epilepsy. Until recently, there were practically no drugs capable of controlling and extinguishing these painful conditions. Such medicines were created only in the middle of the last century, for example, Depakin. What is this drug? It is a strong drug, so you can not use it at your own discretion. If taken incorrectly, side effects of Depakine may occur.
We describe this tool in more detail. "Depakine" is an antiepileptic and anticonvulsant drug. It is active in all types of epilepsy. The medication also reduces the feeling of panic and fear, improves the mood of patients, thereby manifesting their tranquilizing properties. "Depakine" is used in the treatment of epilepsy, which manifests itself in the form of seizures, convulsive syndromes, behavioral disorders, bipolar affective disorders, with the appearance of seizures and tics in children. Side effects of "Depakine", which are noted in his instructions, can occur on the part of various body systems. Therefore, the drug should be agreed with a doctor.
Composition and release forms
Depakine is produced in the following forms:
- Syrup for oral use in 150 ml vials. The package of the drug in the kit contains a dosing double-sided spoon. Syrup before taking mixed with any liquid.
- Coated Depakin Enteric Tablets, 100 pieces per pack. One tablet contains 300 mg of the active ingredient.
- Tablets "Depakine Chrono" in 30 or 100 pieces per pack. One piece contains the active substance 300 mg or 500. "Depakine Chrono" in Latin - DEPAKINE CHRONO.
- Granules "Depakine Chronosphere". They are available in sachets of thirty or fifty pieces per pack. One packet of "Depakine Chronosphere" may contain 100, 250, 500, 750 or 1000 mg of the active ingredient. The maximum concentration of the active substance is determined in the blood seven hours after the use of the drug. The distribution of the drug in the tissues occurs evenly throughout the day. Children are advised to drink this medicine while eating, pouring granules into a drink (for example, in berry or fruit juice). Mixing Depakine Chronosphere with hot food or liquid is not recommended. If the product is given to a baby, it must not be poured into a baby bottle. After mixing the Depakin Chronosphere granules with room temperature water, the prepared solution should be consumed immediately. Chew granules are not recommended. Do not store the prepared solution for a long time (more than half an hour). If the medicinal contents were poured into a glass, then before use, the agent should be well mixed, since the granules of the drug often settle to the bottom of the vessel. Side effects of Depakine Chronosphere will be described below.
- Powder for injection. 400 mg of sodium valproate and 1 ampoule of water for injection per bottle.
Composition of the medicine "Depakine Chrono" (ATX code N03AG01)
This drug is available in the form of elongated white tablets with a risk on both sides. They have no smell and unpleasant taste, but they still do not need to chew them. One dose of Depakine Chrono 500 (ATX code N03AG01) contains the active component in the form of sodium valproate 333 mg and valproic acid 145 mg. One dose of Depakine Chrono 300 contains the active ingredient in the form of 199.8 mg sodium valproate and 87.0 mg valproic acid. Side effects of Depakin Chrono 300 and other medicines will be described in detail below.
Dosage and route of administration of Depakine Chrono
The absorption of Depakin Chrono tablets begins immediately after they enter the stomach. They have a prolonged effect. This leads to the absence of peaks of the active component in the blood plasma and helps to maintain the required concentrations of the active substance for a long period. According to the instructions for use "Depakine Chrono", it should be taken as follows:
- Tablets are taken orally two or three times a day. The medicine can be washed down with a small volume of liquid. Tablets should be drunk without chewing.
- The drug is prescribed for adults and young children weighing more than seventeen kilograms.
- The daily rate of the drug is determined based on the age, weight of the patient. For children under 6 years of age, taking the drug in tablets is not recommended. When assigning a dose, it is necessary to take into account the spectrum of personal sensitivity to valproate. A correlation was found between the dose per day, the concentration of the drug in the blood and the therapeutic effect. Determination of the level of the active substance “Depakine” in blood plasma can be in addition to monitoring the patient in cases where epilepsy is not controlled or if there is a suspicion of side effects of “Depakin”. The range of effectiveness of the drug is, as a rule, from 40 to 100 mg / l.
- The initial dose of the medication should be from 5 to 15 mg / kg per day, in stages, this dose is increased by 5 mg / kg over seven days, to the level of a suitable amount.
- For children from 6 to 14 years, the dose of the drug per day is maximum 30 mg / kg. This calculation is correct with body weight up to 30-40 kg.
- For adolescents from 14 years old, the dosage is 25 mg / kg (with a patient weighing from 40 to 60 kg).
- For adults and adolescents with body weight above 60 kg, the dosage is 20 mg / kg.
- If the frequency of seizures is not controlled at such dosages, they can be increased with strict monitoring of the patient's condition. However, it should be borne in mind that the effect of the drug may be noticeable 4-6 weeks after the start of administration. Therefore, before this time, increasing the dose is not recommended.
- In elderly patients, the dosage is required to be set in accordance with the health status of patients suffering from diseases.
"Depakin Chrono" has the form of a gradual, uniform release of the active component, which leads to a reduction in its concentration in blood plasma and controls it during the day at approximately the same level.
Indications for Depakin Chrono
The medication is prescribed for adults and children as therapy for the treatment of:
- Epileptic seizures.
- Forms of childhood epilepsy.
- Partial epileptic seizures.
- Bipolar affective disorders and their prevention.
"Depakine Chrono" refers to antipsychotics or antipsychotics. These are drugs with a very wide range of prophylactic activity. Their main action is the ability to suppress psychosis and eradicate or significantly reduce its manifestations such as arousal, delirium, anxiety and fear. It is especially worth noting that antipsychotics (antipsychotics) have a number of effects:
- Activating.
- Hypnotic.
- Antidepressant.
- Corrective behavior.
Antipsychotics are successfully used in the treatment of neurotic disorders:
- Obsessive sensations.
- Mood changes.
- Increased and long-lasting panic.
- Lack of sleep.
- Change without cause.
- States with low activity.
- Apathy.
- Digestive disorders against a background of neurosis.
Indications for the treatment of babies
Side effects of Depakine Chrono in children occur quite often. An important aspect in therapy is the inability to distinguish between extensive seizures from local ones. Epilepsy syndrome in young children can go very differently. It is imperative that the drug used against epilepsy has a broad spectrum of action. In our country, for a long time, exclusively drugs of the benzodiazepine group were used (Gidazepam, Diazepam, Clonazepam and others), which by no means in all cases showed their effectiveness.
Reviews about the "Depakine" are mixed. Parents of young patients report its positive and negative actions. A lot of side effects are noted by mothers and fathers of babies who are prescribed this medication. According to the reviews of parents, we can conclude that if your child has not been confirmed with the diagnosis of epilepsy, then it is better to refrain from taking Depakin.
Adverse reactions
Unfortunately, this drug has a lot of them. Therefore, treatment should be carried out under the supervision of a physician. Consider what side effects may occur when taking "Depakine" from the different systems of the body:
Nervous system:
- Tremor.
- Stupor.
- Drowsiness.
- Cramps.
- Headaches.
- Dizziness (occurs with intravenous administration of the drug).
- Memory losses.
- Lethargy.
- Encephalopathy
- Sometimes coma.
- Ataxia.
- Reversible Dementia
With such symptoms, the dosage should be reviewed.
Hematopoietic system:
- Anemia.
- Leukopenia
- Thrombocytopenia.
- Neutropenia
- Macrocytosis.
- Agranulocytosis.
- Hypoplasia (or aplasia) of red blood cells.
- Microcytic anemia.
In such cases, the drug is canceled.
Blood coagulability:
- Bleeding.
- Spontaneous akhimoses.
- Increase INR.
- Increased thrombosed time.
- Hemorrhage.
In these situations, to remove the side effects of Depakin, the drug is canceled, and the patient is examined.
Mind:
- Confusion.
- Impaired attention.
- Aggressiveness.
- Depressive state.
- Decreased learning ability.
- Psychomotor hyperactivity.
Monitoring of the patient's condition and dosage review are required. According to reviews of Depakine, side effects in children are very often accompanied by mental disorders, as well as malfunctioning of the digestive tract.
Digestive system:
- Nausea (very common).
- Hyperplasia of the gums.
- Diarrhea (often).
- Abdominal pain (often).
Cancellation of the drug in this case is not required.
Less commonly observed:
- Pancreatitis (deaths occur).
- Cramping in the stomach.
- Anorexia.
It is recommended to drink the drug during the meal to reduce these symptoms.
Urinary system:
- Enuresis.
- Fanconi's syndrome.
- Tubulointerstitial nephritis.
The immune system:
- Hives.
- Angioneurotic edema.
- Drug rash syndrome.
Skin integument:
- Itching (very common).
- Alopecia.
- Rash.
- Erythema multiforme.
- Stevens-Johnson Syndrome.
- Violations of the nails, hair.
Musculoskeletal system:
- Osteopenia
- Osteoporosis.
- Fractures (due to a decrease in the mineral density of tissues).
- Systemic lupus erythematosus.
- Rhabdomyolysis
Endocrine system:
- Hyperandrogenism.
- Acne
- Inadequate ADH secretion syndrome.
- Hypothyroidism
- Alopecia (male type).
Other violations:
- Deterioration in hearing and vision.
- Failures in the liver.
- Hypothermia.
- The appearance of tumors (cysts, polyps).
- Galactorrhea.
- Breast enlargement.
- Polycystic ovary.
- Infertility (in men).
- Metabolic disease.
- Increased appetite.
- Weight gain.
Contraindications
To eliminate the side effects of Depakin, you need to familiarize yourself with a number of contraindications for taking this medication:
- Increased sensitivity to the components of the drug, such as valproate, divalproate or to any other of the components that make up the current medication.
- Hepatitis is acute or chronic.
- Other liver diseases in the patient or in his relatives.
- Cases of death in the family due to liver diseases that occurred during the use of valproic acid.
- Hepatic perforation.
- In the presence of patient liver dysfunctions. According to reviews, “Depakin” causes side effects against the background of liver pathologies in children more often than in adults. The high-risk group consists of children under three years of age. At the age of over three, the occurrence of such complications is somewhat reduced and gradually decreases with the growth of children. Impaired liver function is often observed during the first six months of treatment, usually between the second and twelfth weeks, and most often when combining antiepileptic drugs. During the first six months of therapy, it is required to regularly check the liver. In case of detection of a very low level of prothrombin, fibrinogen and other negative factors, an increase in the amount of bilirubin and hepatic transaminases, medication should be discontinued.
- Pancreatic inflammation. Complex cases of pancreatitis were sometimes noted, unfortunately, sometimes fatal cases are recorded when using drugs with valproic acid. These facts were observed in patients of different ages and duration of treatment, although it is worth noting that the likelihood of developing inflammation of the pancreas decreases with increasing age of the patients. Lack of liver function in the inflammatory process increases the risk of patient death. It should be noted that during treatment with Depakine, a slight increase in the level of transaminases may be observed. Then patients are strongly advised to conduct an extended examination of the body in the laboratory to review the dosage of the drug, if required according to the analysis. Next, you need to repeat laboratory tests, depending on the change in symptomatic indicators. For children under three years of age, the use of valproate in monotherapy is recommended, but before starting therapy, the real benefits of its use should be evaluated in relation to the likelihood of developing liver or pancreas diseases. Before starting therapy, a blood test should be performed. In acute abdominal pain and symptoms such as nausea, profuse vomiting, it is necessary to stop taking the drug and switch to alternative treatment methods.
- In complex patients with renal failure, it is recommended to take into account the increased concentration of valproic acid in free form in serum and select the appropriate minimum dose of the drug.
- Diseases associated with impaired pigment metabolism (porphyria).
- Concomitant use with drugs used for the prevention or treatment of malaria and containing mefloquine.
- Simultaneous reception with Hypericum perforatum.
- This drug is not recommended for use in combination with other drugs to control epilepsy containing lamotrigine.
- Systemic lupus erythematosus.
- A history of diabetes.
- In the treatment of carbapinems (with mitochondrial ailments).
- Children's age up to six years is a contraindication for taking the drug in tablet form, since there is a possibility of getting into the respiratory tract when taking a medicinal medication.
Childbearing and natural feeding
In women, "Depakine" side effects can cause during the period of gestation. However, the appearance of epileptic seizures at this time can with a high probability lead to the death of the future mother and fetus. Therefore, when prescribing treatment, the doctor must compare the possible risks.
The active substance valproate, according to reports, can have the following effects on fetal development:
- Quite often, from one to two percent of cases, violates the development of the neural tube.
- Improper face development and malformations of the arms and legs (shortening of the limbs).
- The development of heart defects and vascular system.
In order to avoid side effects caused by Depakin in women, a drug can be prescribed by a doctor when carrying a child only in cases where the need for the expectant mother exceeds the risk for the child. If a woman only plans to conceive a child, then she needs to review the indications for the treatment of forms of epilepsy. During pregnancy, do not interrupt the treatment of valproat epilepsy, if it is effective. In such cases, doctors recommend minimizing the effective dose per day, which must be divided into several doses. In addition to existing therapy, folic acid can be prescribed, since it can reduce the likelihood of developing neural tube defects by several times.
Reception "Depakine" side effects for the newborn may have in the form of hemorrhagic syndrome. Unfortunately, fatal cases of the spread of afibrinogenemia have also been reported. Also, in children exposed in the prenatal period to valproic acid, the following effects are noted :
- Lowered attention.
- Autism.
- Lag in development.
- Problems with memorization and learning.
All these risks are lower if a woman is treated with valproic acid monotherapy.
The penetration of valproate into breast milk is quite low, with a concentration between one and ten percent of the serum level of the drug. Expectant mothers can plan natural feeding during the Depakin monotherapy, but the occurrence of adverse reactions, especially hematological disorders, cannot be ruled out. More often, doctors advise replacing this drug with a safer analogue or transferring the child to artificial feeding.
Is nausea in women possible as a side effect of Depakine? The answer is yes. Nausea is the body's most frequent adverse reaction to volproic acid. This symptom is observed in babies. In pregnant women, nausea may increase in the presence of toxicosis. Often, it provokes profuse vomiting, loss of appetite, and general deterioration.
Some features of taking Depakin Chrono
In cases when the patient switches from the tablets of the prolonged action of valproate to the reception of Depakin Chrono, it is required to maintain the previous dosage per day. When replacing other antiepileptic drugs with Depakin Chrono, you should control the transition, do it gradually, reaching the required dose of the active component within two weeks. At the same time, it is necessary to focus on the human condition, to cancel the previous drug not immediately, but gradually reducing its dose. After the final withdrawal of the previous drug within 6 weeks, it is required to monitor the amount of valproic acid in the patient's blood. If necessary, the dose is reduced.
For people who are not taking other medications, the dose should be increased after two or three days in order to achieve the necessary concentration of the drug in about seven days. If necessary, combinations with other agents should be introduced in stages, according to the recommendations of the attending physician on the drug "Depakine".
Overdose
Manifestations of an overdose of "Depakine":
- A coma condition (muscle hypotension, acidosis, respiratory failure, a critical decrease in blood pressure).
- Intracranial hypertension (with cerebral edema).
- Hypernatremia.
Ambulance in case of overdose in stationary conditions should be as follows:
- If Depakin got inside, then it is necessary to wash the stomach, which is effective for twelve hours after using the drug.
- To reduce the adsorption of valproic acid, the use of an adsorbent is recommended. For example, activated carbon.
- It is necessary for the attending physician to monitor the condition of the patient’s heart, vascular and respiratory systems, liver and pancreas.
- Effective urination is required.
- During the recovery period after an overdose, the use of special herbal preparations is necessary for the regeneration of liver cells.
- A diet low in fat and cholesterol is indicated.
- Dialysis is required in very severe cases of overdose.
To prevent poisoning, you must:
- Take the medicine according to the instructions of the attending physician, in stages, strictly following the scheme.
- Remove medication containing valproic acid to avoid overdose.
- In connection with the likelihood of developing pancreatitis, use the medicine in children under three years of age, only by assessing the justification of the consequences.
- Keep the medicine in a place where children cannot reach.
- In case of side effects, Depakia is required to undergo examination in a medical institution.
Fatal cases with an overdose of Depakin are observed, but not very often. Basically, they occur if the patient does not have resuscitation in time.
Interaction with other medicines
Depakin Chrono should not be used in cases of concurrent administration of such drugs:
- Concomitant use with preparations containing mefloquine. The combination of such medicines has a risk of epileptic seizures in patients with epilepsy due to increased metabolism of valproic acid and the convulsive effect of mefloquine.
- Side effects of "Depakine Chrono" 300 or 500 will take place at the same time taking St. John's wort. This is due to a decrease in the presence of valproic acid in blood plasma.
- Side effects of Depakin Chrono 500 or 300 will occur when this drug is combined with other epilepsy control agents containing lamotrigine. With this combination of drugs, severe skin reactions (epidermal necrolysis) are possible. It is worth remembering that an increase in the concentration of lamotrigine in plasma is possible due to a decrease in metabolism in the liver due to the intake of sodium valproate. If a combination of such drugs is necessary, then careful therapeutic and laboratory monitoring is required.
- Parallel administration of Depakine and preparations containing carbamazepine can lead to a decrease in valproic acid in the patient's blood plasma. This will be due to an increase in hepatic acid metabolism by carbamazepine. In such cases, patients are advised to observe in stationary conditions and to review the dosage of drugs, especially at the beginning of therapy.
- Side effects of Depakine Chronosphere in combination with medicines containing carbapenems and monobactams can occur in the form of seizures due to a decrease in the concentration of valproic acid in serum. In such cases, patients are advised to observe with their doctor, control the concentration of drugs in the blood plasma and, if necessary, review the dosage of valproic acid during treatment with an antibacterial drug.
- When taking medication containing felbamate with Depakine, side effects are also possible.
- Very often, in young children, signs of an overdose of phenobarbital or primidone are observed due to taking medications containing them at the same time as Depakine. Moreover, children within fifteen days require a gradual reduction in the dose of phenobarbital or primidone.
- It is not recommended to take "Depakine" simultaneously with drugs containing phenytoin, due to increased liver metabolism.
- A high likelihood of developing hyperammonemia or encephalopathy is attributed to valproic acid when combined with topiramate. The strictest clinical and laboratory control during the first month of treatment is also indicated in the event of symptoms of ammonia.
- "Depakine" increases the toxicity of drugs with zidovudine.
Alcohol interaction
Drinking alcohol together with the drug is extremely dangerous for human health. Ethanol contained in alcoholic beverages, when interacting with valproic acid, enhances its hepatotoxic effect. Alcohol intake during treatment with Depakine has a very difficult effect on the liver.
Special conditions
During the Depakin therapy period it is necessary to be very careful when driving a vehicle and engaging in dangerous types of work that require a high concentration of attention and quick reaction of a person.
Analogs
Depakin has a number of analogues:
- "Convulex". The medication is available in various forms (capsules, solution, tablets).
- "Valparin XP". The drug is approved for children weighing more than twenty kilograms.
- "Encorat." Intestinal tablets are suitable for children over three years of age.
- "Convulsofin." Tablets are prescribed for children from the age of six.
Terms of sale and storage
The purchase of Depakin in a pharmacy necessarily requires a permit (prescription) from the attending medical officer. The average packaging price of Depakin Chrono 300 out of 100 tablets is 1,148 rubles. A package of Depakin Chrono 500 of 30 tablets (such packaging is commercially available today) costs 530 rubles.
To store the medicine you need to find a hard-to-reach place in which the air temperature will not be above +25 degrees. The shelf life of this medication is two years.
Summary
We reviewed the rules for taking Depakin Chrono 300 and the instructions for using Depakin Chrono 500. Reviews about the drug are very mixed. Patients note that it can increase mood, eliminate a sense of anxiety and fear, but it causes inhibition of reactions and motor functions, memory impairment, and a decrease in quick wits. For some, the drug caused unreasonable tantrums, tearfulness, irritability, aggression, which negatively affected work and relationships with others.
Reviews of the side effects of Depakine in children are also common. Parents note that the drug causes nausea and vomiting in babies, delayed reactions. Also, patients note hair loss when taking Depakine, a menstrual cycle failure, and deterioration of the skin of the face.
However, there are patients who are happy with the treatment with this drug. Side effects of Depakin Chrono can be avoided by following the recommendations of the attending physician and constant monitoring of the internal organs. The active ingredient in the drug is sodium valproate.
So, what kind of drug is Depakin? What do patients and doctors say about him? The drug is referred to as a very effective drug against epilepsy. The medicine is appreciated for the prolonged action and more progressive accumulation of the active substance in the tissues of the human brain. The main disadvantage of the drug is the regular occurrence of side effects.