Question: Reaction to Depakote ER? ER physician and regular doc disagree.
Answer:
Full Question:
I was recently diagnosed with occipital
migraines. I have been experiencing them for about a year now. I have them so
frequently that it is very hard to enjoy life. I have been taking Maxalt
for them but I go through a box of it in about a weeks time because I have them
so frequently. I envy the people who only get them once a month. This medication
doesn't help on most of my migraines and I told my neurologist this. He put me
on Depakote ER 500 mg once daily. I took one pill and it stopped my migraine but
it caused a bad side effect. I had to go to the ER because it caused a drug
induced akathesia, which is an involuntary movement disorder. The doctor there
told me to stop the medication that I could not take the medication at all and
to call my doctor immediately. I called and he only lowered the dose to 250 mg
per day. I don't know who to believe. I haven't taken another one of the pills
since. I'm too scared to. Have you ever heard of this happening on Depakote ER?
If you haven't heard of this side effect you don't have to answer this question.
I will not be offended. Another question I have is have you heard of migraines
causing neck pain and making your neck tilt to one side because it causes muscle
spasms? There is nothing wrong with my neck I have had a neurosurgeon and my
neurologist look at my MRIs and they both say my neck is perfectly fine. One
more question I have is my migraines seem to vary in severity and I sometimes
get auras with my migraines when they didn't start out that way. Have you ever
heard of migraines changing in a person? I want to thank you in advance for
reading my email. Tami.
Answer:
Dear Tami;
It's a bit difficult to address your question because doctors use the term "occipital migraines" differently. When going by the International Headache Society's International Classification of Headache Disorders, which is pretty universally accepted, there's no such diagnosis. In our experience, most patients who are given that diagnosis actually have Migraine with aura or Migraine without aura.
In any case, considering the frequency of your Migraines, preventive therapy is quite appropriate. As for the Depakote ER, there are a number of potential central nervous system side effects that can occur in a minority of patients. Your experience could be attributable to the Depakote, but it's difficult for us to say with certainty via the Internet.
Migraine can cause some pain in the neck and shoulders. Your muscle spasms could also be a result of your tensing up during a Migraine attack.
It's not unusual for Migraineurs to experience both Migraine without aura and Migraine with aura. Only approximately 25% of Migraineurs experience aura, and even those Migraineurs seldom experience aura with every Migraine attack. It's also not unusual for Migraine attacks to vary in severity. That said, you need to discuss all of these issues with your doctor to be sure that all of this is indeed Migraine, with nothing else involved.
The bottom line here is that if you and your doctor can't agree on your treatment plan and/or if you don't trust your doctor's judgment about issues such as your medications, you need to find a new doctor. If you need it, there's a link to our directory of recommended specialists below.
Good luck,
Teri Robert and John Claude Krusz
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Published March 27, 2006
