On January 17th, Tuesday I typed in a question regarding long term use of divalproex sodium (25 years) as it affects increase in ammonia levels. I have been on a regime through my PCP of lactulose 2xweek to help evacuate ammonia through my stool......not very pleasant. I've continued to do this for the last 7 months with some success. My ammonia level ranges anywhere from 43 to78 every 2-3 weeks with a blood draw. I've begun to fast before the lab test with mixed results. I take Depakote ER 250mg. tabs at hs. When trying to cut the dosage to 625mg. for 6 weeks I felt very on edge but the ammonia did lower.