Epilepsy in adults and children
Delaying relapse to a mood episode in bipolar disorder in adults
Off-label use as an antidepressant
Supplied in 25 mg, 100 mg, 150 mg, and 200 mg scored, breakable tablets; also in 2 mg, 5 mg, and 25 mg chewable tablets.
Usual dosing is 25 mg QD X 1 week, then increase by 25 mg per week.
Dosing with Depakote or in patients with a history of any drug rash: 12.5 mg X 1 week, then increase by 12.5 mg per week.
Stevens-Johnson Syndrome (a blistering flat rash that may affect the mucous membranes) occurs in about 1/5,000 patients, a risk not greater than with other anticonvulsants. In controlled trials for mood disorders, no cases of Stevens-Johnson occurred out of 1198 patients.
Benign rash occurs in about 8% of patients, no more than placebo in most trials.
Other side effects that occur at a rate greater than placebo, from most to least common: dizziness, headache, nausea, sedation.
Depakote doubles Lamictal levels
Tegretol, Dilantin, Phenobarbital all decrease Lamictal levels by 40%