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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

 

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Divalproex

(Depakote)

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Summary for Lithium

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 for Lithium

  • Treatment of manic episodes of bipolar disorder
  • Long-term maintenance treatment of bipolar disorder

Pros and Cons for Lithium

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

Common Side Effects for Lithium

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 for Lithium

  • 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

Summary for Depakote

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.

Indications for Depakote

Pros and Cons for Depakote

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

Common Side Effects for Depakote

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%)

Warnings for Depakote

  • 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

Prices with our coupons for Lithium vs. Depakote

Price Card Drug Icon
Lithium150 ml / 8meq/5ml
$33.30$160.63
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Divalproex60 tablets / 500mg
$19.09$92.50
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