Review of Depakote in Preventing Migraines

Side effects and drug interactions of Depakote for migraine prevention

Depakote is an anticonvulsant medication used to treat seizure disorders and treat manic episodes in bipolar disorder. It's also considered a "level A" or "effective" medication for preventing migraines, according to the 2012 American Headache Society and American Academy of Neurology treatment guidelines for the prevention of episodic migraines.

A woman suffering from a migraine.
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What Are the Side Effects of Depakote?

Some common side effects of Depakote include gastrointestinal symptoms, like abdominal pain, nausea, vomiting, diarrhea, or constipation, and an increase or decrease in appetite. Common nervous system side effects include dizziness, headache, tremor, problems with walking or coordination, and thinking problems, like memory loss.

Some other side effects include:

  • hair loss
  • fatigue
  • rash
  • weight gain
  • bruising
  • insomnia
  • emotional changes like nervousness or depression
  • visual changes
  • back pain
  • upper respiratory symptoms (i.e., runny nose, bronchitis, etc.)
  • ringing in the ears

A serious side effect of Depakote is that it can cause liver damage, especially within the first 6 months of use. It has also been known to cause fatal pancreatitis, which is inflammation of the pancreas. In addition, Depakote may increase the risk of suicidal thoughts and behavior in a small number of people. Finally, it can cause a low body temperature, drug reaction, as well as drowsiness in the elderly.

Pregnant women should not take Depakote because of its tendency to cause birth defects. Also, Depakote can cause other problems with a patient's blood count, so your healthcare provider may need to order blood tests from time to time while taking Depakote.

Please note that this list is not meant to include all side effects. If you experience any bothersome and/or persistent side effects or have any concerns related to taking Depakote, please discuss them with your practitioner.

Are There Any Medications That Interact With Depakote?

Yes, just as most medications will interact with one or more prescription or over-the-counter remedies, this is the case with Depakote as well. For example, certain medications that pass through the liver, such as phenytoin and carbamazepine, will be metabolized more quickly when you are on Depakote.

This is why it's important to inform your healthcare provider of all the medications you are taking, including over-the-counter medications, herbals, and any vitamins or supplements. Your healthcare provider can help you understand whether or not you should be concerned about medication interactions.

What Does This Mean for Me If I'm Prescribed Depakote?

If you are prescribed Depakote, it's important to take the medication as indicated. Do not stop or change your dose without first consulting your neurologist. With the guidance of your healthcare provider, Depakote can help prevent your migraine attacks, and if it ends up not being the right medication for you, that's okay too. There are a number of migraine preventive options out there.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Loder E, Burch R, Rizzoli P. The 2012 AHS/AAN Guidelines for Prevention of Episodic Migraine: a Summary and Comparison With Other Recent Clinical Practice Guidelines. Headache. 2012;52(6):930-45. doi:10.1111/j.1526-4610.2012.02185.x

  2. National Alliance on Mental Illness. Valproate (Depakote). 2019.

  3. Conner TM, Nikolian VC, Georgoff PE, et al. Physiologically based pharmacokinetic modeling of disposition and drug-drug interactions for valproic acid and divalproex. Eur J Pharm Sci. 2018;111:465-481. doi:10.1016/j.ejps.2017.10.009

Additional Reading
  • Depakote Package Insert. Abbot Laboratories. Revised May 2017.
  • Banner Pharmacaps, Inc. and AbbVie Inc, Approved by the FDA. Medication Guide: Depakote ER, Depakote, Depakene.

By Mark Foley, DO
Mark Foley, DO, is a family physician practicing osteopathic manipulative medicine, herbal remedies, and acupuncture.