Question: DEPAKOTE 500 MG ER TAB (1 TAB IN AM AND 2 TABS AT BEDTIME) RESULTED IN BLOOD LAB VALPROIC ACID TESTING IN THE FASTING MORNING OF 23-JULY-2013, & SINCE PREVIOUS NIGHT. MY VALPROIC ACID LEVEL ON THAT MORNING WAS FOUND AT 83.6 mg/L. THE LAB REFERENCE RANGE STATES THAT IT IS BETWEEN 50.0 TO 100.0 mg/L. MY PSYCHIATRIST WANTS ME TO INCREASE THE DOSAGE TO FOUR (4) TABS: {1 IN THE MORNING, AND 3 TABS AT BEDTIME} SUCH THAT HE WANTS TO SEE MY VALPROIC ACID LEVEL @ 100 mg/L MAXIMUM RANGE. AS A PATIENT AND I RECALL THAT THIS DEPAKOTE MED SIDE-EFFECT IS TOXICITY {OBVIOUSLY AT THE XXXXXXX LEVEL}. WHAT IS GOING ON?

PLEASE NOTE THAT I LOST MY PROSTATE TO CANCER IN OCTOBER 2008. SINCE THEN; I USED TO WAKE UP ABOUT 5 TIMES A NIGHT TO URINATE. I HAD BLOOD LAB WORK END OF MAY 2013: MOST HORRIBLE A1c (I AM DIABETIC) AND THE POOREST LIPID PROFILE SUCH THAT THE TRI-GLYCERIDES WERE OF THE CHART (MY GP HAD HER NURSE CHECK-UP ON ME AND PHONED IF I STOPPED TAKING HER SCRIPTED MEDS;;; WHICH I NEVER DID). I WAS ON 20-MAY-2013 AT 206.6 LBM. I HAD AN APPT WITH MY PSYCHIATRIST ON 10-JUNE-2013, AND TOOK A COPY OF MY LATE MAY-2013 BLOOD TO HIM AND MY FILE. I WAS BEFORE THAT ON TWO BI-POLAR D/O MEDS: (MED 1) 5 TABS DEPAKOTE PER 24 HOURS AND AT 500 MG A TAB ER --- {2 TABS IN AM, AND 3 TABS AT BED-TIME}. (MED 2) ADJUNCT TEGRATOL MED 200 TAB: 2 TABS/24 HRS;;; ONE CARBAMEZEPINE 200 MG IN AM AND ONE AT BED-TIME. BOTH OF DEPAKOTE AND TAGRATOL ARE ANTI-CONVULSIVE; AND SHOULD BE GRADUALLY ADMINISTERED WITH BLOOD TESTING. FOR TWO WEEKS AFTER 10-JUNE-2013 PSYCHIATRIST APPOINTMENT, AND PER HIS INSTRUCTIONS, I TOOK 1 CARBAMEZEPINE @ BED-TME;;; AND 3 DEPAKOTE (INSTEAD OF 5 DEPAKOTE) 500 MG ER DEPAKOTES: "2 AT BED-TIME AND 1 IN MORNING." PER MY PSYCHIATRIST INSTRUCTION, AND AFTER TWO WEEKS OF TAKING ONLY ONE CARBAMAZEPINE; I BEGAN TAKING NO CARBAMEZEPINE;;; AND ONLY TAKE 3 DEPAKOTE 500 MG ER TABS. THEN I WENT FOR A CHECK-UP WITH MY PSYCHIATRIST IN ABOUT A MONTH ON 10-JULY-2013. I FELT BETTER THAN I HAVE EVER FELT. I PUT MYSELF ON A DIABETES DIET AND LOST 16 LBM IN 50 DAYS, AND AFTER JOINING 24 HR FITNESS CENTER ON 20-MAY-2013. I MADE AN APPOINTMENT TO SEE MY PSYCHIATRIST IN 2 MONTHS; PER HIS GUIDELINE, AND ON 17-SEPTEMBER-2013; AND AFTER MY QUARTERLY CHECK-UP WITH BLOOD LABS THAT IS WITH MY GP IN EARLY 2013;;; SUCH THAT I TAKE MY LATE AUGUST 2013 BLOOD LABS COPY TO MY PSYCHIATRIST. FOR 12 DAYS FROM AND FROM 12 JULY TO 23 JULY 2013;;; {12 DAYS: ONE NIGHT, I TOOK 2 TABS OF .25 MG HALCION AND SLEPT FOR 9 HOURS. ON ANOTHER AND VERY SEPARATE NIGHT, I TOOK 1 HALCION TAB AND SLEPT 5 HOURS ... BOTH SLEEPS WERE WAKING UP IN THE MORNING WITH BAD, BAD DROWSINESS;;; WHICH WAS UPON READING SCRIPT FROM MY PSYCHIATRIST, HALCION MUST BE TAKEN W/O ALCOHOL CONSUMPTION; OTHERWISE IT INTENSIFIES THE DROWSINESS. THE OTHER TEN NIGHTS; I WAS LIVING ON 2 TO 3 HOURS SLEEP (AND I FROM MY PAST EPISODES WITH THE BIPOLAR D/O EPISODES THAT SLEEP DEPRIVATION IS MAJOR, MAJOR CONTRIBUTOR TO A MANIC EPISODE ... BUT I ALSO KNOW FROM THE 8 PSYCHIATRISTS I HAVE ALREADY HAD BEFORE MY CURRENT ONE THAT: THERE MORE UNKNOWNS ABOUT MENTAL ILLNESSES THAN THERE ARE THE KNOWN!!). ON 12TH DAY 23-JULY-2013 @ 9:30 AM CST; I PHONE MY PSYCHIATRIST OFFICE AND ASK FOR AN EMERGENCY OUTPATIENT PATIENT APPOINTMENT;;; WHILE I WAITED, THE RECEPTIONIST ASKED THE PSYCHIATRIST, AND SHE SAID TO ME: "CAN YOU COME AT 11:45 AM TODAY 23-JULY-2013?" "YES, I SAID; AND MY WIFE DROVE ME THERE."
MY BLOOD LAB REFERENCE RANGE FOR DEPAKOTE (VALPROIC ACID) IS 50 TO 100 mg/L. I TAKE ONE DEPAKOTE 500 MG ER TAB IN THE MORNING, AND TWO TABS AT BEDTIME. MY VALPROIC ACID BLOOD TEST RESULTS AS OF 23-JULY-2013 WAS 83.6. I AM DIABETIC, ON A DIABETES DIET THAT IS ALSO FOR WT LOSS; I HAVE CHOLESTEROL, HIGH BLOOD PRESSURE, THAT I TAKE MEDS FOR ALL OF THEM. I TAKE 125 MCG LEVOTHYROXINE PER DAY FOR MY THYROID CONDITION FROM SURGICAL REMOVAL OF A LOBE. I AM PROSTATE CANCER SURVIVOR SINCE DECEMBER 2008. AND I HAVE A MENTAL BIPOLAR HEALTH ILLNESS D/O CONDITION FOR WHICH I TAKE DEPAKOTE. I HAVE THIS THEORY ABOUT THE HUMAN BODY: IT IS ALL ONE BODY AND IT IS ALL CONNECTED. IF IT WORKS; DO NOT MESS WITH IT. IT IS JUST THAT I LOOSE THE FOREST FROM THE TREES AS I EVALUATE MY GOOD HEALTH DUE TO LOOSING: "MY FOREST;;; MY BODY, FOR I DIS-SATISFY WITH MY BODY-PARTS (THE TREES);;; AND BECOME VERY FEARFUL OF MY BRAIN'S BIPOLAR MENTAL D/O, WHICH I STRONGLY BELIEVE, THINK, AND FEEL THAT MY PSYCHIATRIST KNOWS ABOUT MY FEARS OF MY VERY OWN BRAIN ... AND I AM NOW KNOWING THAT HE TAKING ADVANTAGE OF MY FEAR, IN A VERY UNJUST AND QUESTIONABLE MANNER THAT IS BY HIM AND HIS STAFF. THANKS.