Epilim: Effect and Side Effects

I used to take Epilim (Depakote, Depakene, Valproic Acid, Divalproex sodium) as a mood stabiliser. When taking it my mood swings stopped and I felt more solid emotionally. However there were problems…it tended to stabilise me in mild depression. It took me a number of months to figure this out, but once I realised it was doing this I stopped taking it.

When I first started taking Epilim (400 mg/day), my life became smoother. I would take the tablets and go about doing the everyday things. My emotions quietly settled down and my mood cycles stopped without me paying any attention to them. Without having to do anything, I simply stopped becoming overwrought, managed stressful periods calmly, and didn’t overreact to anything.

I was able to go back to my regular daily schedules, which no longer seem insurmountably difficult or too slow paced and rigid. In fact, I didn’t need to pay too much attention to being bipolar except to take the medication regularly and marvel at how easy normal people have it.

It was as if the Epilim just calmed the waters. No more roiling emotions. No more cycling. It would have been perfect and I really thought that Epilim would be it, the magic medication to take and forget.

I wasn’t so lucky though. After a while I started becoming resistant to the Epilim, which caused me to destabilise, which caused me to stop taking the medication as my life went haywire.

When I stabilised enough to go to see my psych, she increased my dosage from 400 mg/day to 600 mg/day. It doesn’t seem like much, but it did stabilise me. The increase in side effects, however, was dramatic.

I started feeling really nauseous, as if I wanted to throw up all the time. The intensity varied, but basically for as long as I was awake the sensation was continuous, night and day. The nausea was worst about half hour after I took the tablets (morning and afternoon) and gradually tapered off to just being bad. And as I got hungry, at lunch time or dinner, the nausea would increase, although it was never clear if this was psychological.

I never did throw up, by the way.

This went on for nearly a month. For the first two weeks or so I didn’t mind because I was so desperate to get stable that I would have lived with anything. However, once my moods settle down and I stabilised, the nausea itself began to be a problem. It’s really hard to believe that life is back to normal if you feel as if you want to throw up all the time.

I knew from reading that the side effects of Epilim go away with time, so once I stabilised I kept hoping that the nausea would disappear. But by the end of the third week on Epilim with no abatement of symptoms, I was ready to pack it in and tell my psych to either reduce my dosage or find something else.

I wasn’t keen on either of those options because a lower dosage could mean that I might destabilise again, as I had done the last time. And switching to a new medication would mean trying to find out if would work – a process that would lose me about three to four months of my life as I switched, destabilised, and tried to settle down again.

In the fourth week, the nausea abated. Thankfully.

The nausea wasn’t the only symptom. Along with the nausea came the sensation of acid reflux, as if the upper part of my stomach and my oesophagus was burning. I don’t think it was acid reflux in the conventional sense of the term, but the sensation was there.

I also got photosensitive during the third week I was taking the Epilim at the 600 mg/day. Or maybe I was photosensitive from the start and it only showed up during the third week when I went out in the sun. When I did, it took less than thirty minutes standing outside to get sunburned on my cheeks, which promptly turned a brilliant red and started itching. They didn’t quite peel, but it was close.

I have brown skin, so normally it would take two or more hours in the sun for me to sunburn, something which had not happened since I was in my teens. The experience was so unusual that it took about two days of having red itchy cheeks before it occurred to me that perhaps I was sunburned because the medication was making me photosensitive. That was when I started to carry sunblock (SPF30) in my car.

I also found out that Epilim and alcohol don’t work very well. It was Friday and I was relaxing with friends and I decided to have a beer. However, by the time I had drunk half of the bottle, I was feeling so ill that I really thought I would throw up there and then. The onset wasn’t gradual either. One minute I was fine and two minutes later I was feeling awful. I stayed really nauseous for the next two hours, feeling very miserable and sorry for myself.

I swore off alcohol after that incident. It’s annoying because at my old 400 mg/day dosage I could drink socially (a glass of wine or a beer) with no ill effects. I suppose that I’ll eventually experiment with having a drink again. But not in a hurry. I have no desire to feel that way again.

The Epilim also makes me sleepy. Really sleepy. When I first started taking it I would be groggy all the time. But like the nausea it has faded with time.

But I didn’t notice it initially. While I was home stabilising, I was drinking about four to five cups of coffee per day. And my sleep pattern was shot to hell, so I didn’t notice any grogginess.

Similarly, when I started back work (sorta), I was drinking about four or more cups of coffee a day. Apparently the caffeine cancelled out the sleepiness and I was left feeling more or less normal.

However, I really felt the grogginess the first weekend after I stabilised. I was home, and I usually don’t drink coffee on weekends. I got up at nine, staggered around for forty minutes and went back to bed. Got up at twelve, stayed up for half hour and fell back asleep. This went on all weekend.

It scared me because this is such a classic symptom of depression. I thought I had destabilised all over again. It wasn’t until Monday at work, when the coffee kicked in that I realised what had happened.

I now drink immense amounts of coffee. One cup with breakfast, as much as I feel like during the day, and one or two cups after dinner. If I don’t drink coffee after dinner, I fall asleep within two hours of taking the Epilim.

I get no side effects of coffee. None. I even go to bed when I feel like and fall right asleep.

I also run an elevated body temperature when I am on Epilim, as if I have the flu. It is quite noticeable. C. likes it because I am a warm cuddly person in bed. When I am not on Epilim, my body temperature returns to normal.

When I last started back up taking Epilim I was quite manic. It pulled me back down within a day, which is a bit quick, but I have tended to be a bit sensitive to drugs. However the Epilim didn’t immediately stop the cycling, so I also cycled past normality into a slight depression.

And unfortunately I got stuck in the mild depression as the Epilim kicked in more strongly. Instead of cycling back up out of depression in about three days, which was the cycle pattern at the time, it took a leisurely two weeks to climb back to normality. That was not fun at all.

That seems the way Epilim works with me – as a relatively fast acting anti-manic and as a slower acting mood stabiliser. The stabilising effect kicks in only after I’ve taken it for about two to three weeks and it kicks in progressively, so I have to be careful when I start taking the Epilim to prevent it from prolonging my depressions.

The problem with Epilim is that it is too much of a good thing. I last stopped taking it when I was under high stress because I figured it was one more thing in my life and I could do without it. And why the heck not. I was feeling good.

I immediately started my rapid cycling again. It took nearly two and a half months to get my life back in some semblance of order. Worse than that, stopping the Epilim cold worsened my cycle pattern and instead of a 14-20 day cycle pattern, I ended up with a 6 day cycle pattern, which was terrifying.

I started back up the Epilim and kept taking it every day as I should. However, I eventually ran into a final problem which took me quite a while to figure out. Epilim stabilises me, but it seems to stabilise me at a point were I am not completely functional.

I feel fine, that is, emotionally stable and clear headed. Unfortunately, I was acting as if I were slightly depressed. Everything is hard to do and I have difficulty in completing tasks. It sounds as if it isn’t a major problem, but it was and it affected everything I did.

It took me nearly four months to realise that this was happening. During that time I was waiting for the depression to lift or I assumed that I just needed to get my act together. But I just couldn’t get my life to function properly.

My psych thinks that I might well have stabilised to normal, but because I have gotten used to being hypomanic I cannot be functional at normal. It’s a moot point though – if I’m not functional, then I’m not normal, regardless of what normal means to other people. It could well be that I can only be fully functional when I am slightly hypomanic, but if that’s what it takes, then so be it.

I currently don’t use Epilim anymore, but it remains in my list of available drugs as a mood stabiliser that may need to be taken with an antidepressant.

41 thoughts on “Epilim: Effect and Side Effects

  1. hi
    I care for a patient now taking epilim 700MG per day, my patient has been through much of the same issues you have written, however the big difference is my patient with encouragement has benefited from the epilim by not stopping and starting the medicine, all the side effects were there at some time or another at different levels, but the longer on the medicine they just faded away and my patient now has a very stable life. I beleive if you find a treatment that works for you and the side effects are minimal then sticking with that for the long term will see the greatest benefit. Sunburn, nausea, weight gain, itching skin etc are not serious and do reduce with time, drinking coffee, alcohol, smoking etc are pleasures for many people, however mixed with illness or medication they only worsen side effects and the benefits of the medicine, those are choices people can make, doing without medication is not a good choice if you have a serious disorder.

    • l am a carer, 600ml seroquel and 1200gm eplim per day, works reasonably well for bi-polar sufferer, problem is at night 1 hour approx after taking medication wakes up not in a good mood has to get up to get away from drouzziness, goes back to bed sometimes has nightmares needs to get up to break mood. sometimes high risk of falling throughout night feels like ……..so drugged up very uncomfortable don’t know wether it’s seroquel or eplim not working well.

      • The med Seroquel, I found, was bad for me. Sometimes unable to sleep. But the worst effect for me was the following day when I was dopey and unable to function for the next 10 hours.

    • Most of my life I was on 1500mg to 2000mg of Epilim daily..only about 1,5 year ago I started to have unpleasant side effects.I gained weight,etc..now I try to take only 1000mg at night! Life with super mania is horrible

  2. Thank you so much for sharing i can relate totally. I did the cold turkey option because of not wanting to mix with other drugs and alcohol. I am seeing a new nerologist to get on a better drug.

    Thank you for sharing

  3. I would Really like to no how to get of the epilm (it kills my sex drive) I take 400 night 400 morning . I hate it. But feel like death when I try to cut down. Can you please help me ?? Mark devine

    • Mark, it depends whether you are taking Epilim to stabilise your mood or to manage seizures. Ask your doc about an alternative like lithium if you need a mood stabiliser. I switched from lithium to Epilim and now take 1000mg daily in split dose. I know people who have switched from one to the other and felt better. The transitional period is a pain though; I became quite unwell. So talk to your doc.

    • Trying to get off Epilim myself. Sex drive seems OK, if one accepts “Mrs Palmer and her five daughters” as a means to an end.

      Spousal sex ended five years back.

      I have been on Epilim and one tablet of Cymbalta for about four years. Can’t say if either of them have helped.

      • How are you finding it coming off the epilim ? How much do u take? How much r u coming off at a time ? Do u think it effects your memory ? All the best. Mark

      • Mark, it is too soon to say in my case. I take 400mg in mornings and 600 mg at evening.

        Last two days I have cut back to 400 mg both morning and evening and I will further reduce in 5 days time.

        Part of my withdrawal is that it is complicated by a heavy cold I have had for the past 4 days. I do not attribute that to meds, but to a lowered immune system. It is winter here.

        My main means of tracking/assessing my moods, etc. will be via diary entry and score. At first light, I am 4

      • One other thing I need to reveal is that I am out of work currently. And in the isolation of home so I control how much social interaction I have.

        Part of giving up my meds is the costs of them.

        Mark and others, you do need to make choices for you as an individual. My bipolar is described as cyclothymic, which I have understood in the past as a series of highs and lows.

        Now in my mid fifties, my main concern when fully off my meds is impulse control, as well as monitoring moods.

      • Sex Drive coming off Epilim. My slow reduction still in progress, but “Mrs Palmer” may need to take a holiday.

        Almost at climax on 2 occasions recently, when an extremely severe headache appears from nowhere on the right hand side of my skull, level with my ear. Do not know what causes it, but it stops “Mrs Palmer” dead. Any doctor’s comments?

  4. Ended up at a lovely funeral for my auntie today.

    One of those life events that turns me into an emotional cot case. Will continue with 400mg Epilim morning and night for the time being.

    Mood is positive, around 7.

  5. I take 1500 mg of Epilim daily,,,,but sometimes I feel really low ,and some times too high ! Sleepless nights..4-5 on the row ,or unable to wake up ! Life very often is night mare a

    • That seems like a high dose, but as I have said on this forum before, we are all individuals and we have to trust our doctors AND ourselves to come up with something that “works.” Do you drink alcohol or take other meds that may affect your sleep.
      My own sleeplessness is due to being in an unhappy job situation. I don’t my meds can straighten that out!
      I am in my 60s and about to partly retire and will find it increasingly difficult to afford meds. I am looking into “hypnotherapy cds” as a permanent alternative to the cost of meds. Too early to tell if this will be successful.

      • It is .low. Dose,,,,,.high could be few thousands mg,I do not smoke,drink,using drugs,cooking my own food,simply I am bio polar forever! One day Einstein the second day zombie. Sleeping and dreaming.,,,,,,

      • Mark, I started today to reduce Epilim at night to 200 mg, with 400mg in day times.
        Feeling good with stable positive mood mostly for past 6 days.

  6. Dosage of Epilim is partly based on body weight, so 1500mg is not necessarily a high dose. I think the ratio is 20mg per kg of body weight per day. That means if you weighed 75 kg, then 1500mg would be your maximum daily dose. I could take a higher dose but I have to balance that with side effects (tremor, fatigue, skin rashes). There are so many factors to be taken into consideration, it’s annoying!

  7. Epilim was reported on local TV as being associated with having SPINA BIFIDA in babies. Warnings to women on Epilim to consult with their obstetrician/gynaecologist BEFORE falling pregnant to adjust the dose.

  8. For Mark. I am now off both Epilim and Cymbalta. My mood seemed stable and positive at first. However, over the past 2 weeks I have had considerable joint pain. My mood fell as a result.

    A consult with my psychiatrist revealed that the aches and pains may be due to my brain’s reaction to events in my life and that going back to an effective “anti-depressant” may eliminate the pain.

    We have agreed to continue monitoring the situation.

  9. Noel, I posted on this early noting that I was taking 1000mg. I’ve now had to reduce my dose in half after experiencing sudden rapid weight gain due to fluid retention and subsequent high blood pressure. The reduced dose means I’m getting breakthrough depression and hypomania – manageable (just) – but worse is the pain. I didn’t realise how well Epilim worked against pain. My joints and muscles ache now. Frustrating.

  10. Hi my husband was given Epilim for severe daily headaches 1000 mg a day,but I’ve noticed from the comments that people are taking it for bi polar and depression,is this what it’s usually prescribed for?

    • Nina, I was treated for severe headaches many years ago and a course of SANDOMIGRAN was successful. The side effect is that it increases one’s appetite and hence weight gain.

      My specialist thought I needed to take it for the rest of my life, but I discontinued. I still get an occasional severe headache.

      Hope this helps your husband, Noel

  11. Reading your story shed some light on what I am going through at the moment. I am on 800mg of Epilim a day and I have been on it since I started (2 months ago) and I think its time my phsyc upped my dosage because I’m starting to feel immune to this dosage. I am worried about the headaches, heartburn & nausea. I really can do without that as Epilim has helped me a lot in terms of my mood.

  12. Hi I have been taking epilim now for about 4 years and was on zoloft as well for about 10 years. Stopped taking zoloft after gradually reducing doses about 12 months ago. Have had a tough year with some very low moments but determined to stay off the anti depressants. I have been doing research on the benefits of nutrition and mental health and also found some interesting info about lithium orotate. Has anyone used it with any sucess

    • Brett,
      Your post reminds me that I have been off Epilim and Cymbalta for some 4 months now and I too have been going through “hard times”: sudden episodes of tears, especially in relation to my deceased parents.

      I have finally begun an exercise program based on swimming as it is summer here and I find the exercise is helping my moods. Will follow up later here as i have only been doing it for 1 week.

      Noel

      • I have also found some relief in working out. I do Pilates and it helps me with regulating my moods so do not stop ur swimming it will help a lot! I’m living proof…

    • I have had bad depression turn worse on zoloft. It sent me worse. My uncle was on zoloft and took his life. My mum also had bad experience with zoloft. Yet ive been on Facebook lexapro for 10 yrs or more. Some liws but generally ok

  13. Thanks so much for your experience with epilum. Have had no luck with antidepressants to treat my sadness and anger , dr has suggested epilum, got the script filled but am very reluctant to try it. From your sharing I have decided not to go there.
    Jac

  14. I’ve been taking 800mg of Epilim at night for a few years for bipolar 2 and can’t say I have any side effects. Mind you I can’t remember what I felt like before I started taking it at 600mg dose. I sometimes have to take a low dosage of Olanzapine if I get a bit manic – which makes me tired and zombie-like. But with Epilim I’m full of energy and cheerful – able to exercise and work nornally. I’m tempted to drop the dose to 600mg as I could do with losing some weight (only slightly overweight), and am a little concerned about long term effects on liver etc (although blood tests are normal).

  15. I’ve just finished reading a book by Paul Torday called The Girl on the Landing in which a schizophrenic decides to stop taking his medicine and initially feels much more himself, although he then went on to murder a couple of people. It does paint mental illness in a bad light, but shows quite an insight and is a good read. I think I’ll keep taking my prescribed dose though, as it works well for me. I get a bit of heartburn which could be related, and it doesn’t prevent me from getting stressed all the time. Life can be stressful, after all – so I still need the Olanzapine or Zopiclone sometimes. Whether Epilim causes me any weight gain is difficult to measure – I don’t feel ravenous when on it, although have a healthy appetite (my BMI is 26).
    Olanzapine on the other hand I cannot tolerate well. It does its job of calming me down and is good to take for a few nights to stabilize when required. However, it makes me drowsy the following day, no energy for exercise, listless, a bit depressed and very hungry. Also alcohol doesn’t mix with Olanzapine, but with Epilim I can eat, drink and be merry ..in moderation! Happy Christmas.

  16. I was on Valproic acid (2x500mg) for 25 yrs. It helped me have a successful teaching career but it was tough going. I also took Apo perphenazine 12 mg. I am now retired and lately switched to lamotragine. Lost weight and more energy now. Wish it had been around before. Still taking perphenazine, I will never let that go.

  17. I am really sad for patients and carers having to dish out this medication, I have seen first hand the side effects of long term usage and it his horrid, yet without the medication many times death happens and a beautiful person is lost. I am torn up about this at times and I hope I don’t end up on the same medication. My regret in life is not to have made good use of my brain and be able to do something useful like finding a cure for mental illness. I really admire carers and also people who voluntarily take their medication.

  18. I look after my brother who has a severe brain injury. Everything was pretty good with him for the first few years then suddenly two and half years ago started getting aggressive/angry, (not physically well not yet anyway). Everything that could be checked was checked, (the shunt in his head is working fine), had to have that because of a seizure. Anyway my problem now is he has been on Epilim for several months, he started at 200mg then went to 400mg and now is on 600mg. We have noticed a huge difference especially the last few weeks and now the last few days , behaviour wise he just seems to be so grumpy. We went through a neuropyschiatrist to get the ball rolling on this who is in another town, several trips back to our own doctor and now he won’t play with the medication anymore, I am completely lost and scared as to what to do next, do I decrease it or take him off it cold turkey?? Our own doctor doesn’t want me decreasing it or taking him off it. We are currently waiting on an appointment back to the neuropsych to discuss the medication/issues further but as this is with ACC it is taking time meanwhile I am being yelled at. The only words that seem to come out are ‘whatever’ and ‘sorry’ very loudly and angrily most of the time. We are walking on egg shells with him and cannot go out much as we don’t know what will set him off. He has extremely bad road rage when with his carer and others, not as bad with me. Thanks for reading, guess I just wanted to share and try and unload some of the stress.

  19. I have been prescribed Epilim as a mood stabliser as I suffer from severe anxiety and panic attacks. It seems though, it is prescribed for people with bi polar. My partner who is now my ex has bi polar and doesnt take meds for it. Ironically this is the reason I am now on this medication as going through the manic highs and manic lows with him led, in part, to me developing my own anxiety disorder. Does it really help stabilise your mood? I literally just started taking it today. I was prescribed 100mg twice a day. I have been a guinea pig, first luvox, then pristiq, then Zyprexa. Now Epilim with the pristiq. I just want to feel normal again not like the most simple thing can leave me in a state of panic at the idea of having to do it. Anxiety is like slow torture. It really is. I dont even get a break from it when I sleep as I now have nightmares.

    • K,
      Everyone is different, so to be a guinea pig is what we all are to some extent. If I were you, I would persevere for 2 months to see if there is an improvement.

      In my case, a few things like worry and anxiety, as well as a snoring wife, do interfere with my sleep and my doctor prescribed a mild sedative to help.

      Personally, I believe meds can only help us to “get through” our challenges. They do not return us to “normal”, whatever that is. Another tool that may help you is the use of a relaxation CD. I find that half an hour of this practice can eliminate worry and anxiety and though it is a temporary feeling, it helps to break the cycle of increasing muscle tension. I hope this suggestion helps you.

    • I agree with Noel. You should consider some of the relaxation / meditation techniques. These won’t ‘fix’ the anxiety, but they will provide you with techniques on how to bring the anxiety down from an overwhelming level to something you can cope with. The bad news is that it takes practice to learn them, so they won’t provide you with relief immediately. Which would be nice.

      Here is one technique that I try. I tell myself “There is nothing in the world that will fail if I take a 5 minute time out.” And that’s true – there REALLY isn’t anything that can’t wait 5 minutes. And I try to use the 5 minutes to go somewhere quiet, and take slow breaths, and generally try to calm myself. Notice this doesn’t solve any of the things I am anxious about. But it often lowers the anxiety level, and that’s all I’m after.

      Try it. It’s easy to do, doesn’t cost anything, and you’ll know if it works for you after a few tries.

      I’m also flagging on what you said – “I just want to feel normal again not like the most simple thing can leave me in a state of panic at the idea of having to do it.” To me, that’s a sign of depression, not just an anxiety disorder. It may not be a bad idea to follow up on this with your doc.

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