Re: HELP - Depakote and starting the diet

January 25, 2004

Do you have any idea what ratio you would be at right now?

" (father of ) " wrote:

> Hi

>

> We are starting the diet in the UK, initiating without a fast, and

> we started drastically cutting Carbs over 1 week ago.

>

> Now, our son is showing signs of lethargy, slight drunkeness on and

> off, and his appetite is not good. He is still taking liquids

> though.

>

> We are working towards a 3:1 diet.

>

> I'm worried about toxicity as he is on the same dose of AEDs

> (Depakote and Clobazam) as before we started the diet's gradual

> initiation. I know both these drugs don't mix with the diet.

>

> He is on a relatively high dose of Depakote (34mg/kg/day) but we are

> weaning Clobazam and he is now on a tiny dose (0.2mg/kg/day).

>

> Our dietician and Doctor have no experience of the diet, and they

> are relying on backup support.

>

> We haven't tested for ketones yet as we won't have ketosticks until

> tomorrow.

>

> Our gut feeling is to drop the Depakote immediately to around

> 30mg/kg/day to see if 's toxicity signs subside.

>

> Anyone out there who started the diet with depakote on board -

> please can they advise on the best way to handle this situation.

>

> Kind Regards

>

January 25, 2004

, you described a kid that may be too ketotic. I'd watch

" drastically " cutting the carbs without a doc watching you closely. Have

you downloaded a mealplanner? be sure he gets some carbs.

Kathy

On Sun, 25 Jan 2004 21:57:04 -0000 " (father of ) "

writes:

> Hi

>

> We are starting the diet in the UK, initiating without a fast, and

> we started drastically cutting Carbs over 1 week ago.

>

> Now, our son is showing signs of lethargy, slight drunkeness on and

>

> off, and his appetite is not good. He is still taking liquids

> though.

>

> We are working towards a 3:1 diet.

>

> I'm worried about toxicity as he is on the same dose of AEDs

> (Depakote and Clobazam) as before we started the diet's gradual

> initiation. I know both these drugs don't mix with the diet.

>

> He is on a relatively high dose of Depakote (34mg/kg/day) but we are

>

> weaning Clobazam and he is now on a tiny dose (0.2mg/kg/day).

>

> Our dietician and Doctor have no experience of the diet, and they

> are relying on backup support.

>

> We haven't tested for ketones yet as we won't have ketosticks until

>

> tomorrow.

>

> Our gut feeling is to drop the Depakote immediately to around

> 30mg/kg/day to see if 's toxicity signs subside.

>

> Anyone out there who started the diet with depakote on board -

> please can they advise on the best way to handle this situation.

>

> Kind Regards

>

> " The Ketogenic Diet....a realistic treatment option, NOT just a

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>

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January 25, 2004

paul, we started on epilim and are only now weaning after 3m on the diet.We

had all the signs you said but the hospital said to wait 3m first.

Sorry this is so short, in a rush, email if u have more questions,

Nicola

January 25, 2004

I don't know what ratio we would be at right now - probably close to

a 3:1 but with him eating only intermittently, its difficult to say.

I know he has had a good carb allowance at breakfast yesterday as he

ate his carb allowance (for a 3:1) in the form of breakfast cereal.

The strange thing is that the symptoms I described were worse in the

morning when he had more drug in his system and he got better

through the day when you would have expected his ketones to be

higher.

I have a mealplanner and we have mealplans calculated at 3:1 - I

guess we need to make sure the food is weighed and record exactly

what he is eating.

>

> > Hi

> >

> > We are starting the diet in the UK, initiating without a fast,

and

> > we started drastically cutting Carbs over 1 week ago.

> >

> > Now, our son is showing signs of lethargy, slight drunkeness on

and

> > off, and his appetite is not good. He is still taking liquids

> > though.

> >

> > We are working towards a 3:1 diet.

> >

> > I'm worried about toxicity as he is on the same dose of AEDs

> > (Depakote and Clobazam) as before we started the diet's gradual

> > initiation. I know both these drugs don't mix with the diet.

> >

> > He is on a relatively high dose of Depakote (34mg/kg/day) but we

are

> > weaning Clobazam and he is now on a tiny dose (0.2mg/kg/day).

> >

> > Our dietician and Doctor have no experience of the diet, and they

> > are relying on backup support.

> >

> > We haven't tested for ketones yet as we won't have ketosticks

until

> > tomorrow.

> >

> > Our gut feeling is to drop the Depakote immediately to around

> > 30mg/kg/day to see if 's toxicity signs subside.

> >

> > Anyone out there who started the diet with depakote on board -

> > please can they advise on the best way to handle this situation.

> >

> > Kind Regards

> >

>

January 26, 2004

" (father of ) " wrote:

>

> I have a mealplanner and we have mealplans calculated at 3:1 - I

> guess we need to make sure the food is weighed and record exactly

> what he is eating.

>

I would say so. Also if you continue to see symptoms worse when meds are

highest and improvement when they are not, you might be looking at med

toxicity. Which would mean you need to lower the dose.

Watch out for that eating intermittently stuff though - went on

a food strike at one point, I could hardly get her to eat and what I did

get in was mostly the " dessert " (cream,oil, sweetner and flavouring

whipped together). Didn't realize it at the time but that was the worst

thing I could do when she wasn't eating the rest of it. She got very

gaggy, would even throw up water and very dark on the stix. Psychologist

said leave her own, she will eat when she gets hungry enough. Don't

believe that works when you get into extreme cases on the diet cuz they

are already in ketosis. After about a week and a half we had to switch

her to lower ratio and add in some starch to get her to eat again. You

don't want to go there, where they make themselves really sick from not

eating, trust me.

After the fact, I think the depakote was our culprit, she had been very

difficult to get to eat for the nine months previous to the food strike,

the food strike was after we weaned the depakote and I believe the

change was what pushed her over the edge.

Okay, more than you asked for I geuss, sorry

January 26, 2004