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Compare Lithium vs. Depakote

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

Key takeaways

Lithium (lithium carbonate) and Divalproex (Depakote) are both used to treat bipolar disorder, but they have some key differences. Lithium is a mood stabilizer, while Divalproex is an antiepileptic. Lithium is taken 2 to 3 times a day and comes in various forms, including instant-release pills, oral liquid, and extended-release tablets. Divalproex, on the other hand, is usually taken once or twice daily and is available in delayed-release and extended-release tablets, as well as sprinkle capsules. Lithium requires regular blood tests to monitor levels and prevent toxicity, whereas Divalproex also needs blood tests but mainly to check liver health. Common side effects of lithium include shakiness, thirst, and nausea, while Divalproex can cause nausea, sleepiness, and dizziness. Both medications are available as lower-cost generics. However, Divalproex is not recommended during pregnancy due to the risk of serious birth defects, while lithium is also not recommended but for different reasons, including potential heart issues in the unborn baby.

Lithium
Divalproex (Depakote)
Lithium
Divalproex (Depakote)
Summary of Lithium vs. Depakote
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.
Summary for Antiepileptic
Prescription only
Divalproex (Depakote) is a prescription medication that's used alone or in combination with other medications to treat certain types of seizures. It can also be used to prevent migraines and treat bipolar disorder. Divalproex (Depakote) comes in delayed-release (DR) and extended-release (ER) tablets, as well as sprinkle capsules. You take it by mouth, typically once or twice daily, depending on the formulation. Divalproex (Depakote) can cause changes in weight, both in weight loss and weight gain. Don't suddenly stop taking this medication since it can raise your risk of withdrawal symptoms, including seizures.
Indications of Lithium vs. Depakote
Indications for

•Treatment of manic episodes of bipolar disorder

•Long-term maintenance treatment of bipolar disorder

Indications for

•Bipolar disorder

•Seizures (focal impaired awareness seizure, absence seizure)

•Migraine prevention
Pros and Cons of Lithium vs. Depakote
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

Pros and Const for Antiepileptic
Pros

•Available as a lower-cost generic

•Dose can be adjusted based on your response

•Available in various forms: delayed-release tablets, sprinkle capsules, and extended-release tablets

•Can be used on its own or with other medications to control seizures

Cons

•Can prevent migraines from happening, but it won't help if you have a migraine attack

•Interacts with many medications, such as phenytoin (Dilantin)

•Can’t take while pregnant

•Requires regular blood work and lab tests to make sure your liver is healthy
Common Side Effects of Lithium vs. Depakote
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%)

Common Side Effects for
Bipolar disorder

•Nausea (22%)

•Excess sleepiness (19%)

•Dizziness (12%)

•Vomiting (12%)

•Accidental injury (11%)

•Low energy (10%)

Seizures

•Nausea (48%)

•Headache (31%)

•Feeling weak (27%)

•Vomiting (27%)

•Tremor (25%)

•Dizziness (25%)

•Stomach pain (23%)

Migraine

•Nausea (31%)

•Feeling weak (20%)

•Excessive sleepiness (17%)

•Indigestion (13%)

•Diarrhea (12%)

•Dizziness (12%)

•Vomiting (11%)
Warnings of Lithium vs. Depakote
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

Common Side Effects for

•Liver problems

•Serious birth defects

•Serious pancreas problems

•Suicidal behavior and thoughts

•Lower blood cell counts

•Higher ammonia level in blood

•Severe skin and allergic reactions

•Interaction with other medications
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Compare Lithium vs. Depakote

Key takeaways

Summary of Lithium vs. Depakote

Indications of Lithium vs. Depakote

Pros and Cons of Lithium vs. Depakote

Common Side Effects of Lithium vs. Depakote

Warnings of Lithium vs. Depakote

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