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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 31604
Experience:  Over 20 yrs of Family Practice
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My friend was recently in a behavioral health facility where

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Hello docs,
My friend was recently in a behavioral health facility where he was diagnosed with bipolar I disorder and put on a variety of medications, most notably, depakote. He felt calmer but upon release he abruptly discontinued the depakote, to my disappointment. He is experiencing very bad withdrawal symptoms but refuses to go back on the medication because he is very into fitness and does not like the weight gain side effects. He took himself off cold turkey 4 days ago. He did not suffer any seizures, as I have read that this is a serious potential result of a cold turkey off depakote. Short of going back on the medication (which he is adamant about not continuing) what is the best treatment for him to reduce his withdrawal symptoms? Thanks
Hi What withdrawal symptoms is he having and if he is still on other medications what are they? How long was he on the Depakote?
Customer: replied 4 years ago.

hello dr. Chip,

He is feeling headaches, very little apetite, extreme fatigue, and sometimes hallucinations. He was prescribed depakote along with olanzapine but stopped both because he felt he was gaining weight. He was on the depakote for 2 weeks and a few days.

I assume his doctor doesn't know about his stopping?
Customer: replied 4 years ago.

yes, you are correct. He hated being locked up inside the facility and refuses to go back to that doctor. He is open to seeing a new doctor on an outpatient basis. I told him he would most likely be prescribed the same thing or something similar. He will most likely refuse or discontinue any medication that makes him gain weight. Is there anything we can do now to minimize symptoms?

Well with having been on the Depakote for only about two weeks there isn't much likelihood of seizures but of course he's not out of the woods with that for at least another two weeks. He can try ibuprofen for the headaches and extra vitamin B complex and vitamin C along with magnesium supplements for the fatigue. If his appetite is down he could supplement what he eats with Ensure. All that said, it really isn't a great idea that he did this and he needs to see another psychiatrist as soon as possible.
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Customer: replied 4 years ago.

Thanks for the adivce, dr. I will pass on this info to him and convince him to see a pyschiatrist soon. I believe he will agree to this.

My pleasure--any time. I might add that while I understand his aversion to medications he probably does need to be on something, maybe an SSRI like Zoloft or Effexor