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Since valproate products may produce CNS depression.especially when combined with another CNS depressant (e.g..alcohol).advise patients not to engage in hazardous activities.such as driving an automobile or operating dangerous machinery.until it is known that they do not become drowsy from the drug.

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Concomitant administration of topiramate and valproate has been associated with hyperammonemia with or without encephalopathy in patients who have tolerated either drug alone. Clinical symptoms of hyperammonemic encephalopathy often include acute alterations in level of consciousness and/or cognitive function with lethargy or vomiting. Hypothermia can also be a manifestation of hyperammonemia [see Hypothermia ]. In most cases.symptoms and signs abated with discontinuation of either drug. This adverse event is not due to a pharmacokinetic interaction. Patients with inborn errors of metabolism or reduced hepatic mitochondrial activity may be at an increased risk for hyperammonemia with or without encephalopathy. Although not studied.an interaction of topiramate and valproate may exacerbate existing defects or unmask deficiencies in susceptible persons. In depakote sprinkles generic who develop unexplained lethargy.vomiting.or changes depakote sprinkles generic mental status.hyperammonemic encephalopathy should depakote sprinkles generic considered and an ammonia level should be measured [see CONTRAINDICATIONS and Urea Cycle Disorders and Hyperammonemia ].

Patients should be informed to take Depakote ER every day as prescribed. If a dose is missed it should be taken as soon as possible.unless it is almost time for the next dose. If a dose is skipped.the patient should not double the next dose.

Taking Depakote has been linked to some serious and even deadly side effects.

In some cases.the effect of a barbiturate could increase to toxic levels while the potency of Depakote could decrease.making the medicine ineffective.

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depakote is effective as an anticonvulsant, as well as a mood stabilizer.

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