Living with epilepsy

Epilepsy lifestyle tips As a patient, it is important to educate yourself about your condition and create reliable sources of support. It is also a good idea to help friends and family members understand epilepsy and its triggers. Below are some tips that may be helpful.

BUILD HEALTHY HABITS INTO EVERYDAY LIVING

As you know, living with epilepsy presents unique challenges that may require you to modify your lifestyle and figure out ways to help prevent seizures. Avoiding triggers and knowing how to handle seizures are both essential parts of managing epilepsy, whether you are a person with seizures or a caregiver.

TIPS FOR MANAGING TRIGGERS

Missed treatment doses1
Missing doses of seizure medication is the most common cause of “breakthrough” seizures, and can occur even in patients whose seizures are usually well controlled. Stopping your seizure medication suddenly can cause serious problems, especially in patients with epilepsy. If you miss a dose, take it as soon as possible, unless it is almost time for the next dose. If a dose is skipped, do not double the next dose. Take your regularly prescribed dose. Call your doctor with any questions.

Noise2
People who are affected by noises should talk to their doctor. Using earplugs or earphones in noisy or crowded places, listening to relaxing music, or distracting yourself by singing or focusing on an activity can help.

Bright, flashing, or fluorescent lights3
If you are affected by lights, use polarized or tinted glasses and natural lighting indoors. When riding in a car, focus on distant objects to avoid flickering lights or patterns. Avoid discos, strobe lights, or flashing bulbs on holiday decorations. With a computer, use a monitor with minimal contrast glare or use a screen filter.

Lack of sleep4
Try to regulate your sleeping habits so you have a consistent schedule, which can help you get enough sleep. Keep a log of your sleep patterns, seizures, and general well-being. You may also want to ask a partner to record their observations of you.

Exercise5
Regular exercise is good for everyone, but try to avoid it in the middle of the day during hot weather. Ask your doctor if there are any exercises you should avoid.

Hyperventilation5
Relaxation or slow breathing exercises can help if you are anxious or begin to hyperventilate.

Diet6
A well-balanced diet that you eat at consistent, regular intervals can help you avoid stomach distress and help you remember when to take your medications. Avoid foods and drinks that could aggravate seizures, and make sure to follow advice from your doctor or healthcare professional.

Hormonal changes7
Men and women can both be affected by cyclical changes, so it’s important for everyone to record seizures on a calendar to track them in relation to hormonal changes. If female, keep track of menstrual cycles or symptoms and changes. Track dates and doses of medicines such as hormone replacement therapies and birth control pills. Make sure you talk to your doctor about your use of contraceptives, as some seizure medications could affect their effectiveness.

Illness, fever, and trauma8
Your doctor should know if you become ill or injured, or if you are taking antibiotics, painkillers, or cold medicines. Certain medicines can potentially trigger seizures or interfere with seizure medications, and fever and other illness could make you more susceptible to seizures.

Stress, anxiety, and depression9
Stress can trigger seizures. Keep track of your moods in relation to your stress levels, and use the following techniques to alleviate and control those levels:

  • Counseling and epilepsy support groups
  • Keeping a journal of feelings and thoughts
  • Stepping back from stressful situations
  • Relaxation techniques
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ELIGIBILITY

Available to patients with commercial prescription insurance coverage for Depakote who meet eligibility criteria. Copay assistance program is not available to patients receiving prescription reimbursement under any federal, state, or government-funded insurance programs (for example, Medicare [including Part D], Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs) or where prohibited by law or by the patient’s health insurance provider. If at any time a patient begins receiving prescription drug coverage under any such federal, state, or government-funded healthcare program, patient will no longer be able to use the Depakote Savings Card and patient must call OPUS Health at 800.364.4767 to stop participation. Patients residing in or receiving treatment in certain states may not be eligible. Patients may not seek reimbursement for value received from the Depakote Savings Card from any third-party payers. Offer subject to change or discontinuance without notice. Restrictions, including monthly maximums, may apply. This is not health insurance. Please see full Terms and Conditions.

TERMS AND CONDITIONS

Pharmacist Instructions

  • Submit the copay card authorized for all commercially insured patients by the patient’s primary insurance as a secondary transaction to OPUS Health.
  • When you use this card, you are confirming that you have not submitted and will not submit a claim for this prescription for reimbursement under any federal, state, or government-funded healthcare program, such as Medicare (including Part D), Medicare Advantage, Medicaid, Medigap, Veterans Affairs, the Department of Defense, or TRICARE.
  • Pharmacists with questions please call OPUS Health at 800.364.4767.

WHAT IS DEPAKOTE USED FOR?10-12

Depakote comes in different dosage forms. Depakote® (divalproex sodium) tablets, for oral use, and Depakote® ER (divalproex sodium) extended-release tablets, for oral use, are prescription medications used:

  • to treat manic episodes associated with bipolar disorder
  • alone or with other medicines to treat:
    • complex partial seizures in adults and children 10 years of age and older
    • simple and complex absence seizures, with or without other seizure types
  • to prevent migraine headaches

Depakote® Sprinkle Capsules (divalproex sodium delayed release capsules), for oral use, is a prescription medicine used alone or with other medicines to treat:

  • complex partial seizures in adults and children 10 years of age and older
  • simple and complex absence seizures, with or without other seizure types

IMPORTANT SAFETY INFORMATION10-12

The most important information about Depakote is:

Do not stop taking Depakote without first talking to your healthcare provider. Stopping Depakote suddenly can cause serious problems.

Depakote can cause serious side effects, including:

  • Serious liver damage that can cause death, especially in children younger than 2 years old. The risk of getting this serious liver damage is more likely to happen within the first 6 months of treatment. In some cases, liver damage may continue despite stopping the drug. Call your healthcare provider right away if you get any of the following symptoms: nausea or vomiting that does not go away, loss of appetite, pain on the right side of your stomach (abdomen), dark urine, swelling of your face, or yellowing of your skin or the whites of your eyes.
  • Depakote may harm your unborn baby. If you take Depakote during pregnancy for any medical condition, your baby is at risk for serious birth defects that affect the brain and spinal cord and are called spina bifida or neural tube defects. These defects occur in 1 to 2 out of every 100 babies born to mothers who use this medicine during pregnancy. These defects can begin in the first month, even before you know you are pregnant. Other birth defects that affect the structures of the heart, head, arms, legs, and the opening where the urine comes out (urethra) on the bottom of the penis can also happen. Birth defects may occur even in children born to women who are not taking any medicines and do not have other risk factors. Taking folic acid supplements before getting pregnant and during early pregnancy can lower the chance of having a baby with a neural tube defect. If you take Depakote during pregnancy for any medical condition, your child is at risk for having a lower IQ. There may be other medicines to treat your condition that have a lower chance of causing birth defects and decreased IQ in your child. Women who are pregnant must not take Depakote to prevent migraine headaches. All women of childbearing age should talk to their healthcare provider about using other possible treatments instead of Depakote. If the decision is made to use Depakote, you should use effective birth control (contraception). Tell your healthcare provider right away if you become pregnant while taking Depakote. You and your healthcare provider should decide if you will continue to take Depakote while you are pregnant. Pregnancy Registry: If you become pregnant while taking Depakote, talk to your healthcare provider about registering with the North American Antiepileptic Drug Pregnancy Registry. You can enroll in this registry by calling 1-888-233-2334. The purpose of this registry is to collect information about the safety of antiepileptic drugs during pregnancy.
  • Inflammation of your pancreas that can cause death. Call your healthcare provider right away if you have any of these symptoms: severe stomach pain that you may also feel in your back, nausea or vomiting that does not go away.
  • Like other antiepileptic drugs, Depakote may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying; attempts to commit suicide; new or worse depression; new or worse anxiety; feeling agitated or restless; panic attacks; trouble sleeping (insomnia); new or worse irritability; acting aggressive, being angry, or violent; acting on dangerous impulses; an extreme increase in activity and talking (mania); other unusual changes in behavior or mood. How can I watch for early symptoms of suicidal thoughts and actions? Pay attention to any changes, especially sudden changes in mood, behaviors, thoughts, or feelings. Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you are worried about symptoms.

Do not take Depakote if you:

  • have liver problems
  • have or think you have a genetic liver problem caused by a mitochondrial disorder (e.g., Alpers Huttenlocher Syndrome)
  • are allergic to divalproex sodium, valproic acid, sodium valproate, or any of the ingredients in Depakote
  • have a genetic problem called urea cycle disorder
  • are pregnant and taking Depakote for the prevention of migraine headaches

Before taking Depakote, tell your healthcare provider if you:

  • have a genetic liver problem caused by a mitochondrial disorder (e.g., Alpers Huttenlocher Syndrome)
  • drink alcohol
  • are pregnant or breastfeeding since Depakote can pass into breast milk. Ask your healthcare provider about the best way to feed your baby.
  • have or have had depression, mood problems, or suicidal thoughts or behavior
  • have any other medical condition

Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, herbal supplements.

Taking Depakote with certain other medicines, even for a short period of time, can cause side effects or affect how well they work. Do not start or stop other medicines without talking to your healthcare provider.

Depakote can cause other serious side effects, including:

  • Bleeding problems: red or purple spots on your skin, bruising, pain and swelling into your joints due to bleeding or bleeding from your mouth or nose.
  • High ammonia levels in your blood: feeling tired, vomiting, changes in mental status.
  • Low body temperature (hypothermia): drop in your body temperature to less than 95┬║ F, feeling tired, confusion, coma.
  • Allergic (hypersensitivity) reactions: fever, skin rash, hives, sores in your mouth, blistering and peeling of your skin, swelling of your lymph nodes, swelling of your face, eyes, lips, tongue, or throat, trouble swallowing or breathing.
  • Drowsiness or sleepiness in the elderly. This extreme drowsiness may cause you to eat or drink less than you normally would. Tell your doctor if you are not able to eat or drink as you normally do. Your doctor may start you at a lower dose of Depakote.

Common side effects of Depakote include:

  • nausea
  • vomiting
  • dizziness
  • double vision
  • weight gain
  • problems with walking or coordination
  • headache
  • weakness
  • stomach pain
  • diarrhea
  • hair loss
  •  
  • sleepiness
  • tremor
  • blurry vision
  • increased appetite
  • loss of appetite

Please see the Full Prescribing Information, including Medication Guide, for additional information about Depakote. Talk to your healthcare provider if you have questions.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

If you cannot afford your medication, contact: www.pparx.org for assistance.

REFERENCES

  1. Epilepsy Foundation website. Missed medicines. https://www.epilepsy.com/learn/diagnosis/diagnosis-101/what-tests-are-needed. Accessed April 29, 2018.
  2. Epilepsy Foundation website. Noises. https://www.epilepsy.com/learn/managing-your-epilepsy/managing-triggers/tips-lifestyle-modification/noises. Accessed April 29, 2018.
  3. Epilepsy Foundation website. Bright, flashing, or flourescent lights. https://www.epilepsy.com/learn/managing-your-epilepsy/managing-triggers/tips-lifestyle-modification/bright-flashing-or. Accessed April 29, 2018.
  4. Epilepsy Foundation website. Sleep. https://www.epilepsy.com/learn/managing-your-epilepsy/managing-triggers/tips-lifestyle-modification/sleep. Accessed April 29, 2018.
  5. Epilepsy Foundation website. Exercise and hyperventilation. https://www.epilepsy.com/learn/managing-your-epilepsy/managing-triggers/tips-lifestyle-modification/exercise-and. Accessed April 29, 2018.
  6. Epilepsy Foundation website. Diet. https://www.epilepsy.com/learn/managing-your-epilepsy/managing-triggers/tips-lifestyle-modification/diet. Accessed April 29, 2018.
  7. Epilepsy Foundation website. Hormonal changes. https://www.epilepsy.com/learn/managing-your-epilepsy/managing-triggers/tips-lifestyle-modification/hormonal-changes. Accessed April 29, 2018.
  8. Epilepsy Foundation website. Illness, fever, trauma. https://www.epilepsy.com/learn/managing-your-epilepsy/managing-triggers/tips-lifestyle-modification/illness-fever-trauma. Accessed April 29, 2018.
  9. Epilepsy Foundation website. Stress, anxiety, depression. https://www.epilepsy.com/learn/managing-your-epilepsy/managing-triggers/tips-lifestyle-modification/stress-anxiety-depression. Accessed April 29, 2018.
  10. Depakote [package insert]. North Chicago, IL: AbbVie Inc.
  11. Depakote ER [package insert]. North Chicago, IL: AbbVie Inc.
  12. Depakote Sprinkle Capsules [package insert]. North Chicago, IL: AbbVie Inc.

If you have any questions about AbbVie's Depakote.com website that have not been answered, click here. This website and the information contained herein is intended for use by US residents only, is provided for informational purposes only, and is not intended to replace a discussion with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider and consider the unique characteristics of each patient.

©2018 AbbVie Inc.   North Chicago, IL 60064   US-DPKT-180098   September 2018

WHAT IS DEPAKOTE USED FOR?10-12

Depakote comes in different dosage forms. Depakote® (divalproex sodium) tablets, for oral use, and Depakote® ER (divalproex sodium) extended-release tablets, for oral use, are prescription medications used:

  • to treat manic episodes associated with bipolar disorder
  • alone or with other medicines to treat:
    • complex partial seizures in adults and children 10 years of age and older
    • simple and complex absence seizures, with or without other seizure types
  • to prevent migraine headaches

Depakote® Sprinkle Capsules (divalproex sodium delayed release capsules), for oral use, is a prescription medicine used alone or with other medicines to treat:

  • complex partial seizures in adults and children 10 years of age and older
  • simple and complex absence seizures, with or without other seizure types

IMPORTANT SAFETY INFORMATION10-12

The most important information about Depakote is:

Do not stop taking Depakote without first talking to your healthcare provider. Stopping Depakote suddenly can cause serious problems.

Depakote can cause serious side effects, including:

  • Serious liver damage that can cause death, especially in children younger than 2 years old. The risk of getting this serious liver damage is more likely to happen within the first 6 months of treatment. In some cases, liver damage may continue despite stopping the drug. Call your healthcare provider right away if you get any of the following symptoms: nausea or vomiting that does not go away, loss of appetite, pain on the right side of your stomach (abdomen), dark urine, swelling of your face, or yellowing of your skin or the whites of your eyes.
  • Depakote may harm your unborn baby. If you take Depakote during pregnancy for any medical condition, your baby is at risk for serious birth defects that affect the brain and spinal cord and are called spina bifida or neural tube defects. These defects occur in 1 to 2 out of every 100 babies born to mothers who use this medicine during pregnancy. These defects can begin in the first month, even before you know you are pregnant. Other birth defects that affect the structures of the heart, head, arms, legs, and the opening where the urine comes out (urethra) on the bottom of the penis can also happen. Birth defects may occur even in children born to women who are not taking any medicines and do not have other risk factors. Taking folic acid supplements before getting pregnant and during early pregnancy can lower the chance of having a baby with a neural tube defect. If you take Depakote during pregnancy for any medical condition, your child is at risk for having a lower IQ. There may be other medicines to treat your condition that have a lower chance of causing birth defects and decreased IQ in your child. Women who are pregnant must not take Depakote to prevent migraine headaches. All women of childbearing age should talk to their healthcare provider about using other possible treatments instead of Depakote. If the decision is made to use Depakote, you should use effective birth control (contraception). Tell your healthcare provider right away if you become pregnant while taking Depakote. You and your healthcare provider should decide if you will continue to take Depakote while you are pregnant. Pregnancy Registry: If you become pregnant while taking Depakote, talk to your healthcare provider about registering with the North American Antiepileptic Drug Pregnancy Registry. You can enroll in this registry by calling 1-888-233-2334. The purpose of this registry is to collect information about the safety of antiepileptic drugs during pregnancy.
  • Inflammation of your pancreas that can cause death. Call your healthcare provider right away if you have any of these symptoms: severe stomach pain that you may also feel in your back, nausea or vomiting that does not go away.
  • Like other antiepileptic drugs, Depakote may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying; attempts to commit suicide; new or worse depression; new or worse anxiety; feeling agitated or restless; panic attacks; trouble sleeping (insomnia); new or worse irritability; acting aggressive, being angry, or violent; acting on dangerous impulses; an extreme increase in activity and talking (mania); other unusual changes in behavior or mood. How can I watch for early symptoms of suicidal thoughts and actions? Pay attention to any changes, especially sudden changes in mood, behaviors, thoughts, or feelings. Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you are worried about symptoms.