Please see it is possible the ileostomy has something to do with adequate absorption of Depakote from the gastrointestinal tract
Depakote is a medication which gets absorbed through various portions of the intestine including the lower or distal small intestine too (the ileum), but since you have ileostomy so it is possible there is reduced absorption of Depakote in to your body
This is how this situation can be managed so that you get sufficient mood stabilizer medication in to your blood;
1) One option for you is to increase the daily dose of Depakote further – currently, as per your another question at this site - you seem to be on 125 mg 2 capsules two times per day, which is equal to 250 mg twice daily = 250 mg twice daily = 500 mg per day
Please see 500 mg per day of Depakote for an adult is just the beginning dose, and many patients require larger doses, so one option for you is to try to increase the dose and repeat the blood level after that. And this may help in achieving good Depakote level in the blood. The maximum dose one may try with Depakote is about 3600 mg/day (total daily dose), I am not telling you will require this high dose, but there are some patients who require larger doses to reach sufficient blood level, and as you see you are on small or beginning dose for this medication and there is enough room with the dose for this medication, so this is one option to consider gradually optimise the dose further until the blood level is therapeutic and also you see improve with your symptoms.
2) Another option is to try another mood stabilizer medication which is not much dependent upon the ileum part of the intestine for its absorption. An example of mood stabilizer that is not much dependent upon ileum is Lamotrigine. It is mostly absorbed from the stomach and proximal intestine and not much is absorbed through the lower or distal small intestine like ileum
So if you try lamotrigine then you may absorb sufficient amount of mood stabilizer medication in to the body
So the above are some of the solutions to your situation, and one of the above mentioned approaches can help you in getting sufficient amount of mood stabilizer medication in to your body so that you can enjoy superior control of your symptoms and enjoy superior quality of life.
Wishing you the best health!
All the very best!
Please let me know if you have any additional questions or if you want to discuss this further.
Assuring you the best services!
Dr Subbanna MD