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Neurontin vs Depakote

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Overview

Neurontin Information

Depakote Information

Effectiveness

Dosage Information

Side Effects

Contraindications

Cost

Popularity

Introduction

For patients dealing with epilepsy or other types of seizure disorders, certain drugs help to stabilize and manage symptoms by altering the concentrations of specific compounds in the brain. Neurontin (gabapentin) and Depakote (divalproex sodium) are two such medications often prescribed for these conditions. They each impact different neurotransmitters in the brain but both have significant effects on stabilizing neural activity in patients with epilepsy or seizure disorders. Neurontin is known as an anticonvulsant or anti-epileptic drug that affects chemicals and nerves in the body involved with seizures and some types of pain. On the other hand, Depakote also falls under anticonvulsants; however, it functions by increasing levels of gamma-aminobutyric acid (GABA), a naturally occurring chemical that sends signals throughout your nervous system, thus reducing nerve excitation.

Neurontin vs Depakote Side By Side

AttributeNeurontinDepakote
Brand NameNeurontinDepakote
ContraindicationsShould not be taken with certain other medications without consulting a physician, including MAO inhibitors and certain strong antibiotics. Increased risk of suicidal thoughts or behavior.Should not be taken with certain other medications without consulting a physician, including MAO inhibitors and certain strong antibiotics. Increased risk of suicidal thoughts or behavior.
CostFor brand name, around $600 for 90 tablets of 300 mg. Generic gabapentin can cost as low as under a dollar per day depending on quantity and dosage.For brand name Depakote ER, about $680 for 90 tablets of 500 mg. Generic divalproex sodium ER ranges from around $0.30 to over one dollar per day based on dosage.
Generic NameGabapentinDivalproex Sodium
Most Serious Side EffectIncreased thoughts about suicide or self-harm, signs of an allergic reaction, vision problems, heart problems, low sodium levels, severe nervous system reaction, serotonin syndrome.Signs of an allergic reaction, abnormal bleeding or bruising, unusual weakness or tiredness, visual disturbances, severe stomach/abdominal pain, persistent nausea/vomiting, yellowing eyes/skin (liver damage).
Severe Drug InteractionsInteractions with MAO inhibitors and certain antibiotics.Interactions with MAO inhibitors and certain antibiotics.
Typical Dose900 to 3600 mg/day for adults with postherpetic neuralgia. For children with epilepsy, 10-15mg/kg/day, not to exceed 50mg/kg/day.Starts with 250 mg twice daily, can be increased to a maximum of 1000 mg/day, divided into two doses. Maximum recommended safe dosage is generally considered to be around 60mg/kg body weight per day.

What is Neurontin?

Gabapentin (the generic name for Neurontin) was the first drug of its kind to treat seizures and nerve pain caused by herpes virus or shingles (herpes zoster). It was approved by the FDA in 1993. Gabapentin affects chemicals and nerves in the body that contribute to seizures and some types of pain. Similarly, Divalproex sodium (the generic name for Depakote) is used primarily to treat certain types of seizures and psychiatric conditions such as bipolar disorder, but it can also prevent migraines. Depakote impacts various neurotransmitters, including increasing levels of gamma-Aminobutyric acid (GABA), which moderates nerve conduction into the brain. Both drugs have different side effect profiles due their varied effects on neuronal activities; however, they both aim to balance neural activity in order to reduce symptoms associated with their respective indications.

What conditions is Neurontin approved to treat?

Neurontin is approved for the treatment of various neurological conditions:

  • Partial seizures, both as a standalone therapy and in combination with other drugs
  • Postherpetic neuralgia, a type of nerve pain caused by shingles or herpes zoster
  • Restless legs syndrome

Comparatively, Depakote is used to manage:

  • Various types of seizure disorders
  • The manic phase of bipolar disorder (as monotherapy or in combination with other medications)
  • Prevention of migraine headaches

How does Neurontin help with these illnesses?

Neurontin, also known as Gabapentin, helps manage epilepsy and nerve pain by increasing the concentration of gamma-aminobutyric acid (GABA) between synapses in the brain. It does this by encouraging its production and reducing its reabsorption back into the neurons, thereby maintaining higher levels for longer periods. GABA is an inhibitory neurotransmitter that plays a crucial role in reducing neuronal excitability throughout the nervous system. This function makes it crucial for managing conditions like epilepsy where there is excessive electrical activity in the brain. By increasing GABA levels, Neurontin can limit seizures and help patients manage their condition more effectively.

On the other hand, Depakote or Divalproex sodium increases GABA's effects but not directly; instead, it works to block voltage-dependent channels which indirectly enhances GABA's function leading to reduced neuron firing rates and seizure control.

Both medications aim at calming hyperactive nerves but do so through slightly different mechanisms hence offering alternatives based on individual patient needs or responses.

What is Depakote?

Depakote, also known by its generic name divalproex sodium or valproate, is an anti-epileptic drug (AED) that works by restoring the balance of certain natural substances in the brain. It was first approved by the FDA in 1983 and is used primarily to treat certain types of seizures and bipolar disorder. Unlike Neurontin (generic name gabapentin), Depakote does not work as a GABA analog, meaning it doesn't mimic the action of gamma-aminobutyric acid (GABA), one of your body's primary neurotransmitters for reducing neuron excitability. This difference means that while both drugs can be effective for treating seizures and mood disorders, they have different side effect profiles. Specifically, Depakote may cause less drowsiness than Neurontin but has been associated with other side effects such as weight gain and tremors. The variations between these two medications underline the importance of individual treatment plans tailored to each patient’s specific needs.

What conditions is Depakote approved to treat?

Depakote is a medication approved for the treatment of:

  • Epilepsy (particularly in preventing seizures)
  • The manic phase of bipolar disorders
  • Prevention of migraines

It's crucial to understand that Depakote is not used to relieve an active migraine headache or treat common tension headaches. It's also important to note its use in managing manic episodes associated with bipolar disorder, providing potential relief from extreme shifts in mood, energy, and activity levels.

How does Depakote help with these illnesses?

Depakote, like Neurontin, is a medication used to treat seizure disorders and certain types of pain. However, Depakote acts primarily by increasing the concentration of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter that inhibits nerve impulses, which can reduce seizure activity and pain signals. Furthermore, it has mood-stabilizing properties that make it effective for managing bipolar disorder symptoms as well. While Neurontin also affects GABA levels, its mechanism isn't fully understood and may involve other pathways too. Due to these reasons, if patients do not respond well to typical anticonvulsants or require additional mood stabilization, Depakote might be an appropriate choice either alone or combined with other medications.

How effective are both Neurontin and Depakote?

Both gabapentin (Neurontin) and divalproex sodium (Depakote) are widely utilized in the treatment of seizures, bipolar disorder, and neuropathic pain. They were initially approved by the FDA a few years apart in the early 1990s. Since they work on different pathways within the nervous system, they may be prescribed under varying circumstances. The effectiveness of gabapentin and divalproex sodium was compared directly in several studies; both drugs displayed comparable efficacy levels for managing symptoms of epilepsy and similar safety profiles.

A meta-analysis completed in 2014 noted that gabapentin is effective at reducing neuropathic pain starting from the first week of treatment. Its side effect profile compares favorably to many other anticonvulsants, with fewer instances of severe adverse reactions reported. Gabapentin is also well-tolerated across diverse patient populations including pediatric patients with certain forms of epilepsy as well as adults with post-herpetic neuralgia or diabetic peripheral neuropathy.

In comparison, a review published in 2009 suggested that divalproex sodium seems to be more effective than placebo at treating manic or mixed episodes associated with bipolar disorder, demonstrating equivalent efficacy to many other mood stabilizers. However, due to its potential hepatotoxicity and teratogenic effects during pregnancy, it's often considered only after other first-line treatments have been tried without success or aren't suitable because of specific contraindications.

While significant research has focused on Depakote co-prescribed alongside another mood stabilizer such as lithium for bipolar disorder management - thus confirming its efficacy as part of combination therapy – evidence supporting it as significantly enhancing the effect when added onto an existing regimen still lacks robustness.

Nonetheless, due to their unique pharmacology profiles: Neurontin could serve better those who did not respond positively or experienced undesirable side effects from conventional anti-epileptic drugs while Depakote can potentially fill up gaps left by first-line agents especially among patients presenting complex symptomatology like rapid cycling patterns in bipolar disorders or polytherapy-resistant epilepsies due to multiple seizure types presence.

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At what dose is Neurontin typically prescribed?

Oral dosages of Neurontin range from 900 to 3600 mg/day for the treatment of postherpetic neuralgia in adults. However, studies have indicated that a dosage of 1800 mg/day is typically sufficient for most people. For children and adolescents aged 3-12 years with epilepsy, the dosage can be initiated at around 10-15mg/kg/day and gradually increased over a period of three days to an effective dose. The maximum daily dose should not exceed 50mg/kg/day in children or 3600 mg/day in adults under any circumstances.

On the other hand, oral doses of Depakote for treating manic episodes associated with bipolar disorder starts from a total daily amount of approximately750 mg divided into smaller doses throughout the day. This may be increased rapidly as required up to a maximum dosage between1000 -2000mg per day depending on patient response and tolerance.

Both medications are very different and treat different conditions so it's important to follow your doctor's instructions carefully when taking them.

At what dose is Depakote typically prescribed?

Depakote treatment typically begins with a dosage of 250 mg twice daily. The dose can then be increased to a maximum of 1000 mg/day, divided into two doses, spaced approximately 12 hours apart. If there is no response or if the patient continues to suffer from seizures or bipolar disorder symptoms at this dosage after several weeks, the doctor may increase the dose further. However, any increases should be done cautiously and under close medical supervision due to possible side effects. The maximum recommended safe dosage for Depakote is generally considered to be around 60mg/kg body weight per day.

What are the most common side effects for Neurontin?

Common side effects of Neurontin (Gabapentin) can include:

  • Dizziness
  • Sleepiness/drowsiness
  • Uncontrolled eye movements (nystagmus)
  • Ataxia (loss of full control of bodily movements)
  • Fatigue and general weakness
  • Nausea and sometimes vomiting
  • Tremors or shaking
  • Swelling in your hands or feet

In comparison, common side effects associated with Depakote (Divalproex sodium) are:

  • Dizziness
  • Sleepiness/drowsiness -Nausea/vomiting/indigestion/upset stomach -Diarrhea or constipation -Increased appetite leading to weight gain -Tremor/shaking hands -Hair loss/thinning hair -Loss of coordination/balance issues
    -Dry mouth or increased thirst

Note that everyone reacts differently to medications. If you experience severe reactions, seek immediate medical attention.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Neurontin?

Neurontin and Depakote are both medications used to treat seizures and other neurological conditions. However, they do have potential side effects that you should be aware of:

  • Increased thoughts about suicide or self-harm: This is a potential side effect of both Neurontin and Depakote. If you or a loved one is taking either of these medications and begins to have suicidal thoughts, contact a healthcare professional immediately.
  • Signs of an allergic reaction: Both drugs can cause an allergic reaction, which can include symptoms such as hives, difficulty breathing, swelling in the face or throat, and a severe skin reaction.
  • Vision problems: Both Neurontin and Depakote can cause vision problems, including blurred or tunnel vision, eye pain or swelling, or seeing halos around lights.
  • Heart problems: Both medications can cause fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness.
  • Low sodium levels: Both medications can cause low sodium levels in the body, which can lead to symptoms like headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, or feeling unsteady.
  • Severe nervous system reaction: This can occur with both Neurontin and Depakote, and can include symptoms like very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, or feeling like you might pass out.
  • Serotonin syndrome: While this is more commonly associated with antidepressants, it is a potential side effect of many medications, including Neurontin and Depakote. Symptoms can include agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

What are the most common side effects for Depakote?

Depakote, an anti-epileptic drug used to treat various types of seizure disorders, has possible side effects including:

  • Upset stomach and vomiting
  • Diarrhea or constipation
  • Dizziness or drowsiness
  • Hair loss
  • Changes in weight or appetite
  • Shaking tremors of the hands or feet
  • Vision changes such as blurred sight
  • Unusual bleeding or bruising
    Remember that these are potential side effects. Not everyone who takes Depakote will experience these. Always consult with your healthcare provider if you have any concerns about your medication.

Are there any potential serious side effects for Depakote?

Depakote, like any other medication, can potentially cause side effects. Though these are usually manageable and temporary, serious issues may occur in rare instances. It is crucial to seek immediate medical attention if you experience symptoms such as:

  • Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue or throat
  • Abnormal bleeding or bruising (purple spots under the skin)
  • Unusual weakness or tiredness
  • Visual disturbances including blurred vision and double vision
  • Severe stomach/abdominal pain
  • Persistent nausea/vomiting
  • Yellowing eyes/skin (signs of liver damage)

These could indicate severe adverse reactions to Depakote that require urgent medical intervention. Mental/mood changes such as increased suicidal thoughts should also not be taken lightly and warrant instant communication with a healthcare professional.

Contraindications for Neurontin and Depakote?

Neurontin and Depakote, like all antiepileptic drugs, can increase the risk of suicidal thoughts or behavior in some people. Should you notice your mood worsening, or an increase in depressive symptoms, thoughts of self-harm or suicide while taking these medications, please seek immediate medical help.

Neither Neurontin nor Depakote should be taken if you are using certain other medications without consulting your physician. These include monoamine oxidase (MAO) inhibitors and certain strong antibiotics among others. Always inform your doctor about any medications you are already on; some medicines will require a period to clear from the system to prevent harmful interactions with Neurontin and Depakote.

How much do Neurontin and Depakote cost?

For the brand name versions of these drugs:

  • The price of 90 tablets of Neurontin (300 mg) averages around $600, which works out to about $6.66/day.
  • The price for a 90-tablet supply of Depakote ER (500 mg), on the other hand, is about $680 or approximately $7.55/day.

Thus, if you are in the higher dosage range for Neurontin (i.e., 900 mg/day or higher), then brand-name Depakote may be less expensive on a per-day treatment basis. However, cost should not be your primary consideration when deciding between these two medications.

As for their generic counterparts:

  • Gabapentin (the generic form of Neurontin) is available in packs from 30 up to hundreds of capsules with costs as low as under a dollar per day depending on quantity and dosage.
  • Divalproex sodium ER, the generic version of Depakote ER ranges from around $0.30 to over one dollar per day based on typical dosages and quantities purchased at once.

Generic options offer significant savings compared to their branded counterparts without compromising effectiveness since they contain the same active ingredients.

Popularity of Neurontin and Depakote

Gabapentin, also known by the brand name Neurontin, was estimated to have been prescribed to about 44 million people in the US in 2020. Gabapentin accounted for a significant portion of prescriptions related to neuropathic pain and seizures. It has seen an increase in usage over recent years due to its effectiveness and versatility as it can be used off-label for conditions like anxiety disorder or alcohol withdrawal.

On the other hand, Divalproex Sodium, commonly referred to as Depakote, was prescribed approximately to around 3 million people in the USA during that same year. This medication is primarily used for bipolar disorder treatment and seizure control but also has been employed off-label for migraine prevention. In terms of overall anticonvulsant prescriptions in the US, Depakote accounts roughly for around 10%. Its prevalence has remained relatively stable over the last decade with minor fluctuations.

Conclusion

Both Neurontin (gabapentin) and Depakote (divalproex sodium or valproic acid) are well-established in the management of seizures and bipolar disorder. They also have numerous clinical studies demonstrating their efficacy over placebo treatments. In certain cases, these drugs can be combined under close medical supervision despite some interactions between them. The choice between the two often depends on their different mechanisms of action - with Neurontin working through GABA neurotransmitter modulation, while Depakote acts by increasing brain concentrations of GABA and limiting neuron firing via voltage-gated sodium channel inhibition.

Neurontin is typically used as an adjunctive therapy for partial seizures or nerve pain associated with shingles, whereas Depakote is considered a first-line choice for managing both manic episodes in bipolar disorder and various types of epileptic conditions.

Generic versions are available for both medications, presenting significant cost savings especially for those paying out-of-pocket expenses. The onset timing varies with each drug; hence there may be an adjustment period before noticeable effects occur.

The side effect profiles are somewhat similar between the two drugs which include dizziness, fatigue, weight gain among others although they generally remain well-tolerated by most patients. However, compared to Neurontin's negligible liver implications at standard dosages, Depakote requires careful monitoring due to its potential hepatotoxicity (liver damage). Patients should always closely monitor any unusual symptoms when starting treatment and seek immediate medical attention if they notice worsening mood swings or thoughts about self-harm.

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