This question is for my mother. Due to her mental state she is unable to ask questions. My mother was diagnosed with frontal temporal dementia. She is currently on keppra and depakote for seizures and mood stabilizer. The keppra is for the seizures and the depakote is for her mood. The keppra was at 500 mg but they are increasing it to 750 mg. Not really sure about the depakote. She recently had 2 seizures because of low levels of depakote. Do you think it?s ok to have her ok both medications? I heard that depakote can be toxic if it?s too high and if it?s too low it can cause seizures. Any info or details would be great, thank you.

Dr. Saranya DevanathanPsychiatrist51yrs exp

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Dear Lybrate User, Sorry to hear that your mother Samantha is diagnosed as frontotemporal dementia. Both keppra and depakote are for seizures. It is okay to take 2 tablets to control seizures. Since she is still having seizures, one of them will be increased in dose. It is true that depakote can be toxic in high dose and not control seizures effectively if it is too low. There are labs that do serum valproate level. It will be useful to get proper dose of depakote. It is better to discuss with your doctor by taking the diary of seizures ( date, time, regularity of medicine, any other medicine, any other precipitating factor, food intake and sleep pattern, etc) to decide on dose and timing of dose. These tablets can control seizures - may not reverse dementia. 

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Dr. Prof. Jagadeesan M.S.Psychiatrist18yrs exp

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Both medications have mood stabilising and anti epileptic property, but they need to be given and monitored by a psychiatrist/ neurologist with periodic blood tests and clinical evaluation. They can be combined under expert hands. Good luck.  

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Dr. Krishna MurthyPsychiatrist52yrs exp

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Depakote can be given up to 50 to 80 mgs /kilogram body weight, but the treatng therapist has to monitor for side effects if any.  

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Dr. Saras PrasadPsychiatrist5yrs exp

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Hi depakote at 750 mg is not generally considered very high unless weight of the patient is too low. Medicines for seizures need to be given regularly at same time always without fail and also depakote may be considered to hike a bit if seizures continue. Thanks,  

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