Brief Answer:
Dicorate is safe to use and the line of treatment is appropriate

Detailed Answer:
Hello,

Thanks for choosing HEALTH CARE MAGIC for your health related queries.

He has anxiety disorder and is not attending school since last 6 months. He is on Fluoxetine and Olanzapine and has issues of aggression and mood swings. He has been advised DICORATE 250 for these symptoms.

Dicorate is Divalproex sodium and this is a mood stabiliser drug with good actions in controlling mood swings, aggression and in mood stabilisation.

Now coming to your question-

- The drug is relatively safe to use and at 250 mg it will not cause any serious side effects. Common side effects like sedation, nausea, dizziness, decreased appetite etc., can be seen during start of therapy but these symptoms will improve in a week or two. Other uncommon side effects like asthenia, fatigue, tremors, ataxia etc., are rarely seen. It is known to cause hepatic toxicity in some susceptible individuals, but the risk is more if the drug is used in less than 2 years of age. Non significant rise in lever enzymes can occur with this drug.

I would advise you to get liver function tests done before start of therapy. Over all the drug is safe and there is no significant risk associated with it.

- Yes the drug is a mood stabiliser and it will help in controlling his anger and mood swings. The drug is commonly used in children to reduce anger in conduct disorders. It is a common drug used in bipolar disorder.

Prozac has been prescribed for anxiety and is good anti-anxiety drug. Olanzapine is an antipsychotic drug which is also used as mood stabiliser. The drug has probably prescribed in him to reduce mood swings.

The line of treatment is appropriate.

Thanks, hope this helps you, you can ask again if you have more doubts.

Take Care
Dr. Seikhoo Bishnoi
Consultant Psychiatrist

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Brief Answer:
The drowsiness will last for about a week

Detailed Answer:
Hello again, thanks for asking a follow up question

Yes its normal to feel lethargic and drowsy during first few days of starting divalproex. Possibly due to drowsiness he is feeling introverted. These effects will go in few days. Wait for about a week and he will start tolerating the drug.

The drug is a mood stabiliser and it helps to calm individual by acting on various channels. The drug help to increase the concentrations of GABA (Gamma Amino Butyric Acid). GABA is an inhibitory neurotransmitter in brain and it helps in mood stabilisation.

Thanks, if still have some uncleared doubts don't hesitate to ask again.

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Brief Answer:
Dicorate can cause decrease in appetite and slight increase in weight

Detailed Answer:
Hello again, thanks for asking a follow up question

Yes weight gain is a side effect but that will be not much significant at this dose, even in some patients Dicorate results in reduction of weight. During start of therapy it results in nausea and anorexia or decrease in appetite. Over all effects on appetite are also not much significant.

"In my clinical practice I have noticed reduction of appetite and not much effects on weight."

Yes Olanzapine is one of common drugs that causes increase in weight and appetite.

Prolonged use is not associated with weight gain as the effects are metabolic effects and this is not related to duration of treatment.

It depends upon clinical condition and need for medicines. Sodium Valproate is a mood stabiliser and Olanzapine is an antipsychotic drug with mood stabiliser actions. Both drugs acts by different mechanism of actions. I am prescribing these drugs to my patients simultaneously without any serious side effects. As per my opinion there is no need to stop the drug when a new drug is introduced.

Thanks, hope this helps you.

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