I haven't used the other pills except Dilantin.  They step up the
dosing rate slowly like that so you don't get 'maxed out'  too fast as
the blood levels build up.   And they have you half to 2/3rds the way
to where you're going on the newer pills (depakote) before they reduce
the Dilantin and remove it.   Depending how high a dose you are on
Dilantin, they might slowly reduce that over a week, but could do it
over a longer period.
    Some of the stronger pills (like my Tegretol)  are usually reduced
slower over longer time, but I think Dilantin is more forgiving during
withdrawal.
    You already know to keep us informed how you're doing...   Lots of
people Read here who might use or be considering other medications and
can learn from our successes or not.  Good luck with the Transition.
Heck at this rate you won't even have to make any (many) New Year's
Resolutions..  ;->   G./

I started out at 1000 m.g. three times a day, then after about six
weeks,  went down to 1000 m.g. twice a day to stay in the therapeutic
range of 50-100. I tried 1750 m.g. a day but that left my level out of
the therapeutic range, so I had to go back to 2000 m.g. a day. It
really is personal and depends on your weight, and your metabolism
rate. These are all very specific to the patient, so your neurologist
can best decide what will work best for you.Good Luck,
Jim

Please keep my disclaimer in mind that I am neither a doctor nor a pharmacist.
So what you hear from me is coming from a layperson's interpretation of what he
reads on various pertinent websites. You've probably read that the normal
starting dose for Depakote is 750 mg/da and that may be causing you your
expressed concern. I guess that makes 1500 mg/da sound on the high side.

I think the possible reason is that you are not coming from a fresh new
situation of not using any drugs, but that you are already on another drug and
that drug, in particular, is phenytoin, which has a 2-way interaction with
Depakote. i.e. Depakote has an effect on phenytoin AND phenytoin has an effect
on Depakote. For that reason, I notice, periodic blood serum level tests should
be performed in the early part of the therapy. Was anything said about having
those?

___phenytoin effecting Depakote__
http://rxlist.com/cgi/generic/dival_ad.htm indicates that "For example,
phenytoin, carbamazepine, and phenobarbital (or primidone) can double the
clearance of valproate." In plain English, that means that the phenytoin that
you are taking causes the Depakote to be gotten rid of twice as fast by your
body and perhaps that is why the amount is being doubled to 1500 mg to
compensate. Maybe? Only your doctor really knows. There is also the possibility
of what's known as "loading", which is an attempt to quickly build up the amount
in the body and then back down from that amount, if indicated, to maintain what
is the desired blood serum level for that drug of between 50 to 100 µg/mL.

___Depakote effecting phenytoin__
This one gives some cause for concern, since sites like
http://www.idosi.org/wjms/1(1)2006/13.pdf which says "Serum levels of Phenytoin
in combination with sodium valproate were about 40 percent more than serum
concentration of this drug when used in combination with Phenobarbital.". In
plain English, the effect of the 500 mg phenytoin will climb as though you had
started taking 600?, 700? mg. I can't give you exact numbers, but am just trying
to convey the idea of what will be happening. That along with the added effect
of the new drug!

And simply stop dilantin abruptly?? 500 mg one day and none the next?? That sure
doesn't sound right to me. I'd question the doctor.

Doctors do also make prescribing errors and my own doctor, for example, made one
recently. I needed an antibiotic and he prescribed a dose after checking to make
sure that there would be no bad reactions with my other drugs. The pharmacist
caught the error and I assume because they enter all this in their computer and
the computer caught it. My Dilantin causes the body to destroy the antibiotic
just like the effect it has on Depakote. My doctor was called and he *doubled*
the dose to compensate.

Your doctor might be compensating in the dose of Depakote and have overlooked
the effect on the phenytoin. It's worth asking a few questions in my opinion.

Hi cancer man

I've noticed other people using a certain website that interfaces with these
Usenet newsgroups. You might want to take a look at it and see what you think.

http://www.medkb.com/

The WebTV that you are using does not have a very friendly interface for these
newsgroups and the only way to quote the message that you are replying to is to
copy & paste. That's probably the main reason that you haven't been quoting. If
you use http://www.medkb.com/ the quoting is automatic and I think that you
would find the display to be more helpful to you yourself. It should be much
easier to look at with your WebTV than the way you're doing it right now.