Even small disruptions in brain activity sooner or later turn into serious diseases. One of the most unpleasant and dangerous is epilepsy. Until recently, there were practically no drugs capable of controlling and extinguishing these painful conditions. Such medicines were created only in the middle of the last century, for example, Depakin. What is this drug? It is a strong drug, so you can not use it at your own discretion. If taken incorrectly, side effects of "Depakine" may occur.
Let's describe this tool in more detail. "Depakine" is an antiepileptic and anticonvulsant drug. It is active in all types of epilepsy. The drug also reduces the feeling of panic and fear, improves the mood of patients, thereby showing its tranquilizing properties. "Depakine" is used in the treatment of epilepsy, manifested in the form of seizures, convulsive syndromes, behavioral disorders, bipolaraffective disorders, with the appearance of convulsions and tics in children. Side effects of "Depakine", which are noted in his instructions, can manifest themselves from different body systems. Therefore, taking the drug must be agreed with the doctor.
Composition and release forms
"Depakin" is produced in the following forms:
- Syrup for oral use in vials of 150 ml. The packaging of the drug in the kit contains a dosing double-sided spoon. The syrup is mixed with any liquid before taking.
- Depakine Enteric film-coated tablets, 100 pieces per pack. One tablet contains 300 mg of the active ingredient.
- Tablets "Depakin Chrono" 30 or 100 pieces per pack. One piece contains the active substance 300 mg or 500. "Depakine Chrono" in Latin - DEPAKINE CHRONO.
- Granules "Depakin Chronosphere". They are available in bags of thirty or fifty pieces per pack. One sachet of "Depakine Chronosphere" may contain 100, 250, 500, 750 or 1000 mg of the active ingredient. The maximum concentration of the active substance is determined in the blood seven hours after the use of the drug. The distribution of the drug in the tissues occurs evenly throughout the day. Children are advised to drink this medicine with meals, pouring the granules into the drink (for example, into berry or fruit juice). Do not mix Depakine Chronosphere with hot food or liquid.recommended. If the product is given to an infant, it should not be poured into a baby bottle. After mixing the Depakine Chronosphere granules with water at room temperature, the prepared solution should be consumed immediately. It is not recommended to chew the granules. Do not store the prepared solution for a long time (more than half an hour). If the medicinal contents are poured into a glass, then the product must be well mixed before use, since the granules of the drug often settle to the bottom of the vessel. Side effects of "Depakine Chronosphere" will be described below.
- Powder for injection. For one bottle of 400 mg sodium valproate and 1 ampoule of water for injection.
Composition of the drug "Depakine Chrono" (ATC code N03AG01)
This medicine comes in the form of oblong white tablets scored on both sides. They do not have a smell and an unpleasant taste, but they still do not need to be chewed. One dose of "Depakine Chrono" 500 (ATC code N03AG01) contains the active ingredient in the form of sodium valproate 333 mg and valproic acid 145 mg. One dose of "Depakine Chrono" 300 contains the active ingredient in the form of sodium valproate 199.8 mg and valproic acid 87.0 mg. Side effects of "Depakine Chrono" 300 and other medicines will be described in detail below.
Dosage and method of application of "Depakine Chrono"
Absorption of Depakine Chrono tablets begins immediately after they enter the stomach. They have a prolonged action. This leads to the absence of peaks of the active component in the blood plasma and contributes tomaintaining the required concentrations of the active substance for a long period. According to the instructions for use of "Depakine Chrono", it should be taken as follows:
- Pills are taken orally two or three times a day. The medicine can be washed down with a small amount of liquid. Tablets should be swallowed without chewing.
- The drug is prescribed for adults and young children weighing more than seventeen kilograms.
- The daily rate of the drug is determined based on the age, weight of the patient. Children under 6 years of age should not take the drug in tablets. When prescribing a dose, it is required to take into account the spectrum of personal sensitivity to valproate. A correlation was found between the dose per day, the concentration of the drug in the blood and the therapeutic effect. Determination of the level of the active substance "Depakine" in the blood plasma can be an addition to monitoring the patient in cases where epilepsy is not controlled or there is a suspicion of side effects of "Depakine". The range of effectiveness of the drug is usually from 40 to 100 mg / l.
- Initial dose of medication should be 5 to 15mg/kg per day, gradually increasing this dose by 5mg/kg over a period of seven days to a suitable amount.
- For children from 6 to 14 years old, the maximum dose of the drug per day is 30 mg / kg. This calculation is correct for body weight up to 30-40 kg.
- For adolescents aged 14 years and over, the dosage is 25mg/kg (for patients weighing between 40 and 60kg).
- For adults and adolescents over 60 kg, the dosage is 20mg/kg.
- If the frequency of seizures is not controlled at these dosages, they can be increased with strict monitoring of the patient's condition. However, it should be borne in mind that the effect of the drug may be noticeable 4-6 weeks after the start of administration. Therefore, it is not recommended to increase the dose before this time.
- In elderly patients, the dosage should be set in accordance with the he alth status of patients suffering from diseases.
"Depakine Chrono" has a form of gradual, uniform release of the active ingredient, which leads to a reduction in its concentration in the blood plasma and controls it during the day at about the same level.
Indications for taking "Depakin Chrono"
The drug is prescribed for adults and children as a therapy for treatment:
- Epileptic seizures.
- Forms of childhood epilepsy.
- Partial epileptic seizures.
- Bipolar affective disorders and their prevention.
"Depakin Chrono" refers to neuroleptics or antipsychotics. These are medicines with a very wide spectrum of preventive activity. Their main action lies in the ability to suppress psychosis and eradicate or significantly reduce its manifestations such as agitation, delirium, anxiety and fear. Of particular note is that neuroleptics (antipsychotics) have a number of effects:
- Activating.
- Sleeping pills.
- Antidepressive.
- Corrective behavior.
Neuroleptics are also successfully used in the treatment of neurotic disorders:
- Obsessive sensations.
- Mood changes.
- Increased and long lasting panic.
- Lack of sleep.
- Change for no reason.
- Low activity states.
- Apathy.
- Digestive disorders on the background of neurosis.
Indications for the treatment of babies
Side effects of "Depakine Chrono" in children happen quite often. An important aspect in therapy is the inability to distinguish extensive seizures from local ones. Epilepsy syndrome in young children can be very different. It is essential that the drug used against epilepsy has a broad spectrum of action. In our country, for a long time only drugs of the benzodiazepine group ("Gidazepam", "Diazepam", "Clonazepam" and others) were used, which did not show their effectiveness in all cases.
Reviews about "Depakine" are ambiguous. Parents of young patients report its positive and negative effects. A lot of side effects are noted by mothers and fathers of babies who are prescribed this remedy. According to the parents' feedback, we can conclude that if your child has not been diagnosed with epilepsy, then it is better to refrain from taking Depakine.
Adverse reactions
Unfortunately, this drug has a lot of them. Therefore, their treatmentshould be carried out under the supervision of a physician. Let's consider what side effects can occur when taking Depakine from different body systems:
Nervous system:
- Tremor.
- Stupor.
- Drowsy.
- Convulsions.
- Headaches.
- Dizziness (occurs when administered intravenously).
- Memory gaps.
- Lethargy.
- Encephalopathy.
- Sometimes coma.
- Ataxia.
- Reversible dementia.
If these symptoms occur, the dosage should be reconsidered.
Hematopoietic system:
- Anemia.
- Leukopenia.
- Thrombocytopenia.
- Neutropenia.
- Macrocytosis.
- Agranulocytosis.
- Hypoplasia (or aplasia) of erythrocytes.
- Microcytic anemia.
In such cases, the drug is canceled.
Blood clotting:
- Bleeding.
- Spontaneous akhymosis.
- Increased INR.
- Increase in thrombosed time.
- Hemorrhages.
In these situations, to remove the side effects of Depakine, the drug is canceled, and the patient is examined.
Psyche:
- Confusion.
- Attention disorder.
- Aggressiveness.
- Depressive state.
- Decrease in learning ability.
- Psychomotor hyperactivity.
Requires monitoring of the patient's condition and revision of the dosage. According to reviews about"Depakine", side effects in children are very often accompanied by mental disorders, as well as malfunctions of the digestive tract.
Digestion system:
- Nausea (very common).
- Gingival hyperplasia.
- Diarrhea (often).
- Abdominal pain (common).
Withdrawal of the drug in this case is not required.
Less common:
- Pancreatitis (some fatalities).
- Stomach cramps.
- Anorexia.
It is recommended to drink the drug during meals to reduce these symptoms.
Urinary system:
- Enuresis.
- Fanconi syndrome.
- Tubulointerstitial nephritis.
Immune system:
- Urticaria.
- Angioedema.
- Drug Rash Syndrome.
Skin:
- Itching (very common).
- Alopecia.
- Rash.
- Erythema multiforme.
- Stevens-Johnson syndrome.
- Nail, hair disorders.
Musculoskeletal system:
- Osteopenia.
- Osteoporosis.
- Fractures (due to decreased tissue mineral density).
- Systemic lupus erythematosus.
- Rhabdomyolysis.
Endocrine system:
- Hyperandrogenism.
- Acne.
- Syndrome of inappropriate secretion of ADH.
- Hypothyroidism.
- Alopecia (male type).
Other violations:
- Hearing and vision impairment.
- Failures inliver function.
- Hypothermia.
- The occurrence of tumors (cysts, polyps).
- Galactorrhea.
- Breast Enlargement.
- Polycystic ovaries
- Infertility (in men).
- Metabolic disorders.
- Increased appetite.
- Weight gain.
Contraindications
To exclude the side effects of "Depakine", you need to familiarize yourself with a number of contraindications to taking this medication:
- Increased sensitivity to drug ingredients such as valproate, divalproate or any of the other ingredients in the active drug.
- Hepatitis, acute or chronic.
- Other liver disease in patient or relatives.
- Family deaths due to liver disease during valproic acid use.
- Hepatic perforation.
- In the presence of dysfunctions of the patient's liver. According to reviews, the side effects of "Depakine" against the background of liver pathologies in children causes more often than in adults. The high-risk group is children under three years of age. Over the age of three, the occurrence of such complications is somewhat reduced and gradually decreases with the maturation of children. Liver dysfunction is often observed during the first six months of treatment, usually between the second and twelfth weeks, and most often when antiepileptic drugs are combined. During the first six months of therapy, it is required to regularly check the functioning of the liver. If very low levels of prothrombin, fibrinogen andother negative factors, an increase in the amount of bilirubin and hepatic transaminases, drug therapy should be discontinued.
- Inflammation of the pancreas. Complicated cases of pancreatitis have sometimes been noted, unfortunately, deaths are sometimes recorded when using drugs with valproic acid. These facts were observed in patients of different ages and duration of treatment, although it is worth noting that the likelihood of developing inflammation of the pancreas decreases with increasing age of patients. Insufficiency of the liver during the inflammatory process increases the risk of death of the patient. It should be noted that in the treatment of "Depakine" there may be a slight increase in the level of transaminases. Then patients are strongly advised to conduct an extensive examination of the body in the laboratory in order to revise the dosage of the drug, if required by the analysis. Further, it is required to repeat laboratory tests, depending on the change in symptomatic indicators. For children under three years of age, the use of valproate in monotherapy is recommended, but before starting therapy, the real benefit of taking it in relation to the likelihood of developing liver or pancreatic diseases should be assessed. Before starting therapy, a blood test should be performed. For acute abdominal pain and symptoms such as nausea, profuse vomiting, stop taking the drug and switch to alternative methods of treatment.
- Complexin patients with renal insufficiency, it is recommended to take into account the increased concentration of free-form valproic acid in serum and select the appropriate minimum dose of medication.
- Diseases associated with impaired pigment metabolism (porphyria).
- Concomitant use with medicines used to prevent or treat malaria that contain mefloquine.
- Simultaneous reception with St. John's wort.
- This medicine is not recommended for use in combination with other epilepsy medicines containing lamotrigine.
- Systemic lupus erythematosus.
- History of diabetes mellitus.
- When treated with carbapinems (for mitochondrial ailments).
- Children under six years of age is a contraindication for taking the drug in tablet form, as there is a possibility of getting into the respiratory tract when taking the drug.
Carrying a baby and breastfeeding
In women, "Depakine" can cause side effects during the period of bearing a child. However, the appearance at this time of epileptic seizures can most likely lead to the death of the expectant mother and fetus. Therefore, prescribing treatment, the doctor must compare the possible risks.
The active substance valproate is reported to have the following effects on fetal development:
- Quite often, between one and two percent of cases, neural tube development is disrupted.
- Improper development of the face and vicesdevelopment of arms and legs (shortening of limbs).
- Development of heart defects and vascular system.
In order to avoid the side effects caused by "Depakine" in women, the drug can be prescribed by a doctor when carrying a child only in cases where the need for the expectant mother outweighs the risk to the child. If a woman is only planning to conceive a child, then she needs to reconsider the indications for the treatment of forms of epilepsy. During pregnancy, do not interrupt the treatment of epilepsy with valproate if it is effective. In such cases, physicians are advised to reduce to a minimum the effective dose per day, which must be divided into several doses. In addition to existing therapy, folic acid may be prescribed, as it can reduce the likelihood of developing neural tube defects by several times.
Taking "Depakine" side effects for a newborn may be in the form of a hemorrhagic syndrome. Unfortunately, cases of the spread of afibrinogenemia with a fatal outcome have also been recorded. Also, in children exposed to valproic acid in utero, the following effects are noted:
- Reduced attention.
- Autism.
- Developmental delay.
- Problems with memory and learning.
All these risks are lower if the woman is treated with valproic acid monotherapy.
Penetration of valproate into breast milk is quite low, with concentrations between one and ten percent of the drug's serum level. future mothersmay plan breastfeeding during Depakine monotherapy, but the occurrence of adverse reactions, especially hematological disorders, cannot be ruled out. More often, doctors advise replacing this drug with a safer analogue or transferring the child to artificial feeding.
Is nausea possible in women as a side effect of "Depakine"? The answer is yes. Nausea is the most common adverse reaction of the body to volproic acid. This is also seen in babies. In pregnant women, nausea may increase in the presence of toxicosis. Often it provokes profuse vomiting, loss of appetite, general deterioration.
Some features of taking Depakin Chrono
In cases where a patient switches from tablets of non-prolonged action of valproate to taking "Depakine Chrono", it is required to maintain the same dosage per day. When replacing other antiepileptic drugs with Depakine Chrono, the transition should be monitored, done gradually, reaching the required dose of the active ingredient within two weeks. In this case, it is necessary to focus on the state of the person, to cancel the previous drug not immediately, but gradually reducing its dose. After the final withdrawal of the previous drug for 6 weeks, it is required to monitor the amount of valproic acid in the patient's blood. If necessary, the doses of its reception are reduced.
For people not taking other medications, doses should be increased after two or three days to reach the desired concentrationdrug for about seven days. If necessary, combinations with other drugs should be administered in stages, according to the recommendations of the attending physician about the drug "Depakine".
Overdose
Manifestations of an overdose of "Depakine":
- Coma condition (muscle hypotonia, acidosis, respiratory failure, critical decrease in blood pressure).
- Intracranial hypertension (with cerebral edema).
- Hypernatremia.
Ambulance for overdose in hospital should be as follows:
- If "Depakine" got inside, then it is necessary to perform a gastric lavage, which is effective within twelve hours after taking the drug.
- To reduce the absorption of valproic acid, an adsorbent is advised. For example, activated carbon.
- Requires supervision of the attending physician for the condition of the patient's heart, vascular and respiratory systems, liver and pancreas.
- Maintain effective urination required.
- During the recovery period after an overdose, special herbal preparations are needed to regenerate liver cells.
- Low fat and low cholesterol diet shown.
- Dialysis is required for very severe cases of overdose.
To prevent poisoning you need:
- Take the medicine as prescribed by the attending physician, step by step, strictly following the scheme.
- Remove receptionmedicines containing valproic acid to avoid overdose.
- Due to the likelihood of developing pancreatitis, use the medicine in children under three years of age, only after evaluating the justification of the consequences.
- Keep medicine out of reach of children.
- When side effects of "Depakia" require an examination in a medical facility.
Deaths from an overdose of "Depakine" are observed, but not very often. They mainly occur if the patient does not take resuscitation in time.
Interaction with other drugs
"Depakine Chrono" should not be used in cases of concomitant use of such drugs:
- Simultaneous administration with drugs containing mefloquine. The combination of such drugs has a risk of epileptic seizures in patients with epilepsy due to increased metabolism of valproic acid and the convulsant action of mefloquine.
- Side effects of "Depakine Chrono" 300 or 500 will occur with simultaneous administration of St. John's wort. This is due to a reduction in the presence of valproic acid in the blood plasma.
- Side effects of Depakine Chrono 500 or 300 will occur when this drug is combined with other epilepsy control products containing lamotrigine. With this combination of drugs, severe skin reactions (epidermal necrolysis) are possible. It is worth remembering that an increase in plasma concentrations of lamotrigine is possible due to a decrease in liver metabolism.due to sodium valproate. If a combination of these drugs is necessary, careful therapeutic and laboratory monitoring is required.
- Parallel administration of "Depakine" and preparations containing carbamazepine can lead to a decrease in valproic acid in the patient's blood plasma. This will be due to the increase in hepatic acid metabolism under the action of carbamazepine. In such cases, patients are advised to observe in a hospital and review drug dosages, especially at the beginning of therapy.
- Side effects of "Depakine Chronosphere" in combination with medicines containing carbapenems and monobactams may manifest as convulsions due to a decrease in the concentration of valproic acid in serum. In such cases, patients are advised to observe the attending physician, control the concentration of drugs in the blood plasma and, if necessary, revise the dosage of valproic acid during antibacterial therapy.
- When taking medications containing felbamate with Depakine, side effects are also possible.
- Very often in young children there are signs of an overdose of phenobarbital or primidone due to taking medications containing them, simultaneously with Depakine. At the same time, children within fifteen days require a gradual reduction in the dose of phenobarbital or primidone.
- It is not recommended to take "Depakine" simultaneously with drugs containing phenytoin, due to increased hepatic metabolism.
- High probabilitythe development of hyperammonemia or encephalopathy is attributed to valproic acid when combined with topiramate. The strictest clinical and laboratory control during the first month of treatment is also indicated in case of symptoms of ammonemia.
- "Depakine" increases the toxicity of drugs with zidovudine.
Interaction with alcohol
The use of alcoholic beverages together with the drug is extremely dangerous for human he alth. Ethanol contained in alcoholic beverages, when interacting with valproic acid, enhances its hepatotoxic effect. Alcohol intake during treatment with Depakine is very hard on the liver.
Special conditions
During the period of therapy with Depakine, you must be very careful when driving a vehicle and engaging in hazardous types of work that require a high concentration of attention and speed of human reactions.
Analogues
"Depakin" has a number of analogues:
- "Convulex". The drug is available in different forms (capsules, solution, tablets).
- "Valparin XP". The drug is approved for children weighing more than twenty kilograms.
- "Enkorat". Enteric tablets are used for children over three years of age.
- "Konvulsofin". Tablets are prescribed for children from the age of six.
Terms of sale and storage
The purchase of "Depakine" in a pharmacy necessarily requires permission (prescription) from the attending medical officer. average pricepackaging "Depakina Chrono" 300 out of 100 tablets is 1148 rubles. A package of "Depakine Chrono" 500 of 30 tablets (such packaging is currently on sale) costs 530 rubles.
To store the medicine, you need to find a hard-to-reach place where the air temperature will not be higher than +25 degrees. The shelf life of this medicine is two years.
Results
We reviewed the rules for taking "Depakine Chrono" 300 and the instructions for using "Depakine Chrono" 500. Reviews about the drug are very mixed. Patients note that it can improve mood, eliminate feelings of anxiety and fear, however, it causes inhibition of reactions and motor functions, memory impairment, and a decrease in intelligence. For some, the drug caused unreasonable tantrums, tearfulness, irritability, aggression, which negatively affected work and relationships with others.
Reviews of the side effects of "Depakine" in children are also common. Parents note that the drug causes nausea and vomiting in babies, delayed reactions. Also, patients note hair loss when taking "Depakine", failure of the menstrual cycle, deterioration of the skin of the face.
However, there are patients who are satisfied with the treatment with this drug. Side effects of "Depakine Chrono" can be avoided by following the recommendations of the attending physician and constant monitoring of the state of internal organs. The active ingredient in the medicinal product issodium valproate.
So, what is this drug - "Depakin"? What do patients and doctors say about him? The drug is referred to as a very effective drug against epilepsy. The drug is valued for its prolonged action and more progressive accumulation of the active substance in human brain tissues. The main disadvantage of the drug is the regular occurrence of side effects.
