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Compare Depakote vs. Lithium

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Divalproex (Depakote) and lithium (Lithobid) are both used to treat bipolar disorder, but they belong to different medication classes. Divalproex is an antiepileptic, while lithium is an antimanic. Divalproex is also used to treat seizures and prevent migraines, whereas lithium is specifically for treating manic episodes and long-term maintenance of bipolar disorder. Divalproex comes in various forms, including delayed-release tablets, extended-release tablets, and sprinkle capsules, and is typically taken once or twice daily. In contrast, lithium is available as instant-release pills, oral liquid, and extended-release tablets, and is usually taken 2 to 3 times a day. Both medications require regular blood tests to monitor their levels and potential side effects, due to a risk of toxicity if levels become too high. Common side effects of divalproex include nausea, sleepiness, and dizziness. Lithium can also cause nausea, sleepiness, and dizziness, as well as increased thirst, and frequent urination. Neither medication is recommended during pregnancy due to potential risks to the fetus.

Divalproex (Depakote)
Lithium
Divalproex (Depakote)
Lithium
Summary of Depakote vs. Lithium
Summary for Antiepileptic
Prescription only
Divalproex (Depakote) is an antiepileptic medication used to treat certain types of seizures, bipolar disorder, and prevent migraines. The medication comes as delayed-release (DR) tablets, extended-release (ER) tablets, and sprinkle capsules. You take it by mouth, either once a day or in divided doses, depending on your condition and the form that's prescribed. Common side effects include stomach pain, hair loss, and diarrhea. Serious risks include liver problems, inflammation of the pancreas, and birth defects if taken during pregnancy.
Summary for Antimanic
Prescription only
Lithium carbonate (or lithium) is a medication used to treat bipolar disorder and manic episodes. It's taken by mouth, typically 2 to 3 times a day. Lithium is available as instant-release pills and oral liquid as well as an extended-release tablet (brand name Lithobid). All lithium products are available as lower-cost generics. Lithium works well for treating bipolar disorder, but it can also cause side effects, such as shakiness, thirst, and nausea. To prevent lithium toxicity, your provider will check your blood lithium levels to make sure you're on a safe dose of the medication.
Indications of Depakote vs. Lithium
Indications for

•Bipolar disorder

•Seizures

•Migraine prevention

Indications for

•Treatment of manic episodes of bipolar disorder

•Long-term maintenance treatment of bipolar disorder
Pros and Cons of Depakote vs. Lithium
Pros and Const for Antiepileptic
Pros

•Used for seizures, bipolar disorder, and migraine prevention

•Dose is adjusted based on your response

•Available in multiple forms

•Can be used alone or with other medications

Cons

•Won't help if you have a migraine attack

•Interacts with many medications

•Not safe to take in pregnancy

•Requires regular blood work and lab tests

Pros and Const for Antimanic
Pros

•Works well for bipolar disorder

•Starts to work in about 1 to 3 weeks

•Available as a lower-cost generic

•Available as oral pills and oral liquid for those having trouble swallowing pills

Cons

•Can have a lot of side effects, including lithium toxicity if lithium levels are too high

•Requires routine blood tests to check the medication levels and how the medication is affecting your body

•Not the best option for people with severe kidney problems

•Interacts with a lot of medications such as non-steroidal anti-inflammatory drugs (NSAIDs), diuretics, and ACE-inhibitors
Common Side Effects of Depakote vs. Lithium
Common Side Effects for
Bipolar disorder

•Sleepiness (19-26%)

•Indigestion (9-23%)

•Nausea (19-22%)

•Vomiting (12-13%)

•Dizziness (12%)

•Accidental injury (6-11%)

•Stomach pain (9-10%)

•Weakness (6-10%)

Seizures

•Nausea (48%)

•Headache (31%)

•Weakness (27%)

•Vomiting (27%)

•Sleepiness (27%)

•Tremor (25%)

•Dizziness (25%)

•Stomach pain (23%)

Migraine

•Nausea (15-31%)

•Weakness (20%)

•Sleepiness (7-17%)

•Infection (15%)

•Indigestion (7-13%)

•Diarrhea (7-12%)

•Dizziness (12%)

•Vomiting (7-11%)

Common Side Effects for
Adults:

•Hand trembling

•Excessive urination

•More thirst

•Nausea

•General discomfort when you start treatment

Children (7 to 17 years of age):

•Nausea or vomiting (57%)

•Urinating more often (38%)

•Tremor (32%)

•Feeling more thirsty (28%)

•Tiredness (26%)

•Higher thyroid hormone levels (25%)

•Dizziness (23%)
Warnings of Depakote vs. Lithium
Common Side Effects for

•Liver problems

•Birth defects

•Inflammation of the pancreas

•Suicidal thoughts or behavior

•Bleeding and blood conditions

•High ammonia levels

•Low body temperature

•Severe skin reactions

•Serious allergic reaction

•Sleepiness in older adults

•Interaction with other medications

Common Side Effects for

•Lithium toxicity

•Kidney problems

•Serotonin syndrome

•Thyroid problems

•Heart problems (Brugada syndrome)

•Low blood sodium levels

•High blood calcium levels and high parathyroid hormone levels

•Brain-related side effects
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Compare Depakote vs. Lithium

Key takeaways

Summary of Depakote vs. Lithium

Indications of Depakote vs. Lithium

Pros and Cons of Depakote vs. Lithium

Common Side Effects of Depakote vs. Lithium

Warnings of Depakote vs. Lithium

Prices with our coupons for Depakote vs. Lithium

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