Depakote (Divalproex Sodium) for Migraine

What Members Say Top Tips Side Effects Copay Help FAQs

Depakote (divalproex sodium) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to prevent migraine in adults.

What Members Say

MHT logo These insights are based on 93 comments about Depakote from MyMigraineTeam members. These are the experiences of a small number of individuals and are not meant to be medical advice.

Benefits:

Daily preventive use can lower migraine frequency and reduce pain intensity.
Depakote in combination with other preventives can feel more effective for some.
Some find Depakote more manageable than other migraine medicines they previously tried.

Considerations:

Somnolence (sleepiness) and fatigue are common and can carry into the next day.
Nausea, vomiting, abdominal pain, and diarrhea can be hard to tolerate.
Serious risks include liver problems, pancreatitis, suicidal thoughts, and major pregnancy-related harm.

How Depakote Works and How It’s Taken

Depakote is a type of valproate medicine. It works in the brain, but its exact way of working is not fully known. It may increase levels of GABA, which is a brain chemical that helps calm nerve cell activity.

In migraine, this may help reduce abnormal nerve cell activity involved in migraine attacks. Doctors prescribe Depakote when adults need a medicine to help prevent migraine headaches.

Depakote is given as a tablet by mouth, typically twice daily.

Typical Dosing for Migraine

The recommended starting dose of Depakote for migraine is 250 milligrams twice daily. For people who respond to treatment, the recommended maintenance dose is up to 1,000 milligrams per day.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Depakote

MHT logo These insights are based on 93 comments about Depakote from MyMigraineTeam members.

Members who use Depakote often say it can take trial and error to find the right migraine plan. They also frequently mention paying attention to side effects, staying in close contact with a neurologist, and setting realistic expectations about how fast Depakote may work or how much it may help.

1

Talk to your doctor about side effects that affect daily life.
“I have been on Depakote for almost two months, and I have had tremors. They are getting worse now. I sometimes can’t think of the word I wanted to say, and I am like in a fog.”
2

Be patient, and expect some trial and error.
“It has taken several years and several doctors to get to this treatment. So don’t give up.”
3

Ask your doctor about preventive options if one treatment is not enough.
“Talk to your doctors about trying different preventatives. Gabapentin and Depakote are two examples of these. I only recently started finding relief when I changed from the topiramate to the Depakote.”

Connect with others who understand life with migraine. Join MyMigraineTeam for free.

Depakote Side Effects

In clinical trials of Depakote for preventing migraine headaches in adults, the most common side effects occurred in about 6 percent to 31 percent of people. They include:

Nausea
Asthenia (weakness or low energy)
Somnolence
Dyspepsia (upset stomach)
Diarrhea
Dizziness
Vomiting
Abdominal pain
Tremor (shaking)
Weight gain
Back pain
Alopecia (hair loss)
Increased appetite

Serious Side Effects and Warnings

Depakote can cause serious side effects that may require immediate medical attention. These include:

Serious liver damage — This can be life-threatening and usually occur in the first six months. Symptoms can include severe tiredness, loss of appetite, vomiting, belly pain, dark urine, or yellowing of the skin or eyes.
Fetal harm — Major birth defects, lower IQ, and neurodevelopmental disorders can occur. Depakote must not be used to prevent migraine headaches during pregnancy, and it is contraindicated for migraine prevention in people who can become pregnant if they are not using effective contraception.
Pancreatitis — Dangerous inflammation of the pancreas can occur. Symptoms can include severe abdominal pain that may spread to the back, nausea, vomiting, or loss of appetite.
Suicidal thoughts or behavior — New or worsening depression, mood changes, or thoughts of self-harm may occur.
Hyperammonemic encephalopathy — High ammonia levels can cause confusion, extreme sleepiness, vomiting, or changes in alertness.
Drug reaction with eosinophilia and systemic symptoms (DRESS) — This severe allergic reaction can include fever, rash, swollen lymph nodes, facial swelling, organ problems in multiple organs, and high levels of white blood cells.
Severe skin reactions — These can include Stevens-Johnson syndrome and toxic epidermal necrolysis, which are serious rashes with blistering or peeling skin.
Angioedema — Swelling of the face, lips, mouth, or throat can affect breathing.
Bleeding and blood disorders — These can include thrombocytopenia (low platelets), which can cause unusual bruising or bleeding.
Hypothermia — Low body temperature can occur.

Get medical help right away if you think you are having a serious reaction.

How To Save on Depakote

AbbVie, the manufacturer of Depakote, offers the Depakote Savings Program. Eligible people with commercial insurance may pay as little as $5 per month.

The Depakote Savings Program is not available to people receiving prescription drug coverage through a federal, state, or government-funded healthcare program. To learn more, visit the Depakote Savings Program, or call 833-440-2659.

What To Know Before Taking Depakote

Before starting Depakote, your doctor will do blood tests to check your liver.

Tell your doctor if you have any allergies to divalproex sodium, sodium valproate, valproic acid, or any ingredients in Depakote. Do not take Depakote if you have had an allergic reaction to divalproex sodium, sodium valproate, or valproic acid.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements. Using Depakote with other medicines can cause serious side effects. Do not start or stop other medicines without talking to your healthcare provider.

Do not take Depakote if you:

Have liver problems
Have or think you have a genetic liver problem caused by a mitochondrial disorder, such as Alpers-Huttenlocher syndrome
Have a genetic problem called a urea cycle disorder
Are pregnant, or can become pregnant and are not using effective birth control

Depakote is also FDA-approved to treat manic episodes associated with bipolar disorder and certain seizure disorders.

Depakote ER is a different product with the same active ingredient as Depakote, yet different recommendations for doses and timing of doses. Do not mix up Depakote with Depakote ER. Check with your healthcare provider if you are unsure which product you are supposed to take.

If you miss a dose, take it as soon as you can unless it is almost time for your next dose. Do not take two doses at the same time.

If you are pregnant, may become pregnant, planning to become pregnant, or breastfeeding while taking Depakote, talk with your doctor about the risks and benefits of Depakote for migraine prevention. Because of the risk to the fetus of decreased IQ, neurodevelopmental disorders, and major congenital malformations, including neural tube defects, do not take Depakote if you are pregnant. If you can become pregnant, use effective contraception while taking Depakote.

Depakote can pass into breast milk. Effects are not well established and may harm your baby. Talk to your healthcare provider about the best way to feed your baby if you take Depakote.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Depakote?

In two clinical trials for migraine prevention, Depakote lowered the average number of migraine headaches over four weeks compared with placebo (an inactive treatment).

How long does Depakote take to work for migraine?

In studies, Depakote for migraine prevention was evaluated over four-week treatment dose-adjustment periods. It is unknown exactly how many days it takes to start working.

Can Depakote cause weight gain with migraine prevention?

Yes. In studies, weight gain was reported in 8 percent of people taking Depakote. Increased appetite was also reported in 6 percent of people taking Depakote.

Can Depakote cause sleepiness or tremor when used to prevent migraine?

Yes. In studies, somnolence was reported in 17 percent of people taking Depakote, and tremor was reported in 9 percent.