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Valproic Acid (Depakote) For Anxiety: Can Depakote Help With Anxiety Symptoms?

Last Updated: August 26, 2022

Depakote is used “off-script” by many performers, musicians, and others suffering to help with anxiety issues; performance anxiety, social anxiety, or otherwise. Here we look at what Depakote is, how it works against anxiety, compare it to other alternatives like beta-blockers & natural supplements, examine any side-effects and long-term downsides, and figure out if Depakote is effective against anxiety.

Are you considering Depakote for Anxiety because you experience severe nerves and anxiety whenever you have to go on stage and perform in front of an audience?

Perhaps you have experienced the trembling hands, increased heart rate and profuse sweat that can come with severe stage fright, sometimes to the point where it hinders your ability to perform at your absolute best.

Or perhaps you’re not a “performer” in the traditional sense, as in a public speaker or a musician, but you still suffer from jitters and nerves in high-pressure situations like job interviews, critical exams or even social events like a dinner party or a date.

If any of the above sounds even vaguely familiar, you should know that you are not alone in your suffering! Performance anxiety, sometimes called stage fright, affects millions of people around the world and is extremely common. At the center of performance anxiety is a fear of being judged negatively because of your performance, even if there’s no real evidence to justify this.

Many professional performers, from musicians to stand-up comedians and others who suffer from anxiety, turn to Depakote, or similar drugs like Clonidine or Atenolol, to help them manage their anxiety symptoms. Here in this article, we will look at how Depakote works for anxiety, what potential side-effects Depakote may have, Depakote dosages for anxiety, some natural & activity-based alternatives to depakote and everything else you should consider before using depakote to help with your anxiety symptoms.

But before diving into why Depakote may help some performers with their anxiety symptoms, let’s take a look at why you experience performance anxiety, stage fright and/or social anxiety in the first place. Knowing why you experience anxiety symptoms will help you better understand how drugs like depakote, or similar alternatives, may be effective against your performance anxiety symptoms.

Why do I experience performance anxiety?

For the majority of people, there are two layers to anxiety symptoms: the root underlying causes of social or performance anxiety, and the physical manifestation of those anxiety symptoms.

Root causes of performance anxiety

The root causes of performance anxiety can be a combination of a few different factors, including the following [8].

  • Your parent’s/teacher’s expectations of you when you were a child
  • Past negative experience with performances or social situations
  • If you’re physiologically more likely to experience anxiety
  • If you were bullied at a young age

These are just a few examples, and the list is not comprehensive. The best way to get to the root causes of your anxiety is to work with a qualified therapist.

Physical Symptoms of Anxiety

The physical symptoms of performance anxiety are varied and typically a combination of a few or all of these symptoms [9].

  • Shaky voice
  • Dry mouth
  • Trembling hands
  • Too much sweating
  • Racing heartbeat
  • Nausea
  • Sense of nervousness in the gut
  • Panic attacks in severe cases

If you’ve experienced stage fright before, then you know that it can get bad to the point where the symptoms can really effect your performance.

And performance anxiety spares no one. It is blind to levels of fame or success.

There are well-known cases of world-famous performers/artists like Adele, Hugh Grant, Taylor Swift, Barbara Streisand, just to name a few, that have suffered from debilitating anxiety to the point where they contemplated quitting acting or performing altogether.

So it is not surprising at all that so many people seek out solutions to their performance anxiety symptoms through medications like Depakote; it’s almost out of necessity in a lot of cases! So next, let’s look at how Depakote works to fight your anxiety symptoms…

What is Depakote and how does it work to help with anxiety symptoms?

Depakote, generic name divalproex sodium, belongs to a class of medications known as anticonvulsants. Anticonvulsants are sometimes taken to treat the manic episodes associated with bipolar disorder and Depakote is commonly prescribed when patients experience rapid cycling of mood episodes.

Depakote is formed by adding sodium hydroxide to two valproic acid molecules, yielding a molecule that is double the size of Depakene, but which gets broken back down to simple valproic acid in the stomach [1]. Valproic acid (Depakene), Valproate sodium (Depacon) and Divalproex sodium (Depakote) are all different forms (and brand names) of depakote but the important thing to know is that they are all eventually converted into valproic acid in the body.

Depakote works by calming the hyperactivity of the brain during mania and manic episodes. It is also used to treat seizures and prevent migraine headaches [2]. Depakote was originally developed as an epilepsy medication and besides it’s usage for bipolar manic episodes, is also also used for several off-label conditions, anxiety being one of them and depression, schizophrenia symptoms and schizoaffective disorder some of the others.

Why do performers take Depakote?

Divalproex (brand name of Depakote) is often used to treat anxiety symptoms by performers, musicians, and others seeking help with their anxiety problems: performance anxiety, social anxiety, or otherwise.

There are several studies showing that depakote can be effective against anxiety symptoms. One example, an open clinical trial with 10 patients suffering from panic disorder, found that Divalproex (Depakote) had the potential to reduce panic symptoms and anxiety while also improving unstable mood [3].

In another randomized, placebo-controlled trial of 17 patients who suffered from social anxiety disorder, Depakote was shown to reduce anxiety symptoms in approximately half of the patients [4].

Performers and anxiety-sufferers are discovering what the studies point to: that depakote may be the drug of choice to help reduce anxiety symptoms. But how does depakote compare to other anxiety-reducing medications like beta blockers and natural alternatives?

Is Depakote a beta-blocker?

Beta-blockers, or their full medical name beta-adrenergic blocking agents, have a primary function of blocking the release of adrenaline and other stress hormones in the body. Beta blockers are typically prescribed for health conditions like high blood pressure, angina (chest pains), irregular heart rhythm (arrhythmia), and migraines [5].

As we write about in this beta blockers for anxiety article; is commonly known that beta-blockers are also commonly used “off-script” by performers to deal with anxiety and stage fright. In fact, a survey performed in 1987 by the International Conference of Symphony Orchestra Musicians, representing the largest group of orchestras in America, found that almost 30 percent of the musicians surveyed had used beta-blockers to help reduce & manage their performance anxiety symptoms [6].

We’ve already established that an exaggerated stress response, like when you experience performance anxiety, is associated with a dramatic spike in adrenaline. By blocking the effects of adrenaline with beta blockers, you’re preventing adrenaline from binding to the beta receptors in the heart. This means that beta-blockers essentially block the physical symptoms of performance anxiety.

When you take a beta-blocker, it can slow your heart rate, reduce any trembling and sweating, and regulate your breathing and blood pressure. It can help you feel relaxed, essentially negating the stress response to help you get through the performance [7].

As Valproic acid (Depakote) is an epilepsy medication that is now used for the treatment of panic attacks as well as other psychiatric problems and bipolar disorders, and it belongs to a class of medications called anticonvulsants, Depakote is not classed as a beta blocker.

Medications & beta-blockers like Propranolol, Metoprolol and Clonidine are prescribed to treat high blood pressure (hypertension) when not used off-script for anxiety, and they all do so through different mechanisms within the body. Depakote is designed to reduce panic and mania symptoms when not used “off-script”, so it is a fundamentally different medication.

Usage of any of these mentioned drugs & medications without professional medical assistance and advice is NOT advised. Please seek professional medical assistance if you are currently combining beta blockers with depakote, as there can be interaction issues between the medications.

Depakote Mechanism of Action

The mechanism of action of Divalproex is not yet completely understood. Research suggests that Valproic acid (the active form of the drug) may have several different mechanisms, including [10]:

  • Increasing levels of GABA, an inhibitory neurotransmitter that reduces over-stimulation in the brain.
  • Reducing excessive communication between neurons by blocking voltage-gated sodium and calcium ion channels in the brain, which is a common trigger for seizures.

There is also some emerging research showing that Depakote may inhibit an enzyme called Histone Deacetylases (HDAC) [11]. And researchers are currently exploring Valproic acid’s potential anti-cancer effects due to its ability to inhibit HDACs [12][13].

What is the recommended Depakote dosage for anxiety?

The FDA recommends that Depakote dosage for treating mania begin at 750 mg daily. The maximum recommended dosage is 60mg/kg per day (as in 60mg for every kg of body weight, per day).

Depakote typically comes in 250mg and 500mg capsules, and the recommended dose for anxiety is primarily based on body weight and age. According to the FDA [14], initial depakote doses for anxiety are: “Start at 250 mg twice a day, can be increased to a max of 1000 mg daily”

Are there any downsides or side-effects to using Depakote for anxiety?

Depakote is generally well-tolerated when not taken alongside other medications. It has no habit-forming potential, but it is not recommended that you discontinue use of the drug before talking with your doctor, as withdrawal symptoms can occur in some cases.

There are, however, some potential side-effects of Depakote that you should be aware of before taking the medication [2]:

  • Headaches
  • Sleepiness
  • Nausea
  • Tremors
  • Fatigue
  • Vomiting
  • Dizziness
  • Blurred vision
  • Stomach pain
  • Diarrhea
  • Weight gain
  • Hair loss
  • Coordination problems

In most recorded cases of people suffering from these side effects with depakote, they usually subside in a few weeks. If you experience any of these depakote side-effects, please seek assistance from a medical professional immediately to ensure that there isn’t any health complications.

It’s worth noting that there are instances of bruising or bleeding occurring when Depakote is taken with aspirin. Depakote can also cause excessive sedation with alcohol and also with Klonipin or other benzodiazepines [15]. Generally speaking, it is not advised to take depakote alongside other medications.

Long-Term Side Effects

Depakote, used consistently, can cause liver damage, and the risk is more likely to occur during the first 6 months of taking the medication. Signs might include nausea or vomiting, loss of appetite, abdominal pain, dark-colored urine, facial swelling, and yellowing of the skin or white of eyes. Cases of pancreatitis among children and adults taking the medication have also been reported [2]. If you experience any of these symptoms, please seek medical assistance immediately.

As the manufacturers of depakote state themselves, do not take depakote if you [16]:

  • 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 taking it to prevent migraine headaches and are either pregnant or may become pregnant because you are not using effective birth control (contraception)

Depakote requires a prescription

Do note that, assuming your doctor approves of you taking depakote for your anxiety, and writes a prescription, you’ll have to refill that prescription every time you run out.

This will not be an issue if you only plan on using depakote a few times. But if you start using Depakote more often, then it could become a significant inconvenience.

Are there any natural alternatives to Depakote?

If you’re not too excited about becoming dependent on depakote when you want or need to perform, or having to deal with the potential side-effects, or just having to get a prescription whenever you run out, you may be wondering if there are natural alternatives to depakote.

A natural alternative would achieve the same end-result, which is to provide relief from symptoms of performance anxiety.

But a good alternative to depakote would do so by supporting your mind and body in a way that, over time, makes you more resilient. You’d become better equipped to handle any stress responses that come your way and learn to think about your performances in a way that makes them less stressful, to begin with.

The most effective natural remedy to performance anxiety that I know of is PerformZen, which I reviewed here.

PerformZen has proved extremely effective, in my experience, at treating performance anxiety as it contains a combination of GABA & L-theanine, which help boost mental clarity; Theacrine, which aids mental clarity and energy; Ginkgo Biloba, which is an effective stress reducer; plus vitamins and minerals like Magnesium & Vitamin B6, which have proven effective in reducing even severe cases of stress.

This combination provides the positive anti-anxiety effects of Depakote, but also boosts alertness and mental clarity, which are more subtle symptoms of performance anxiety that depakote does not address. Overall, this may mean a natural solution such as PerformZen is not only safer, but more effective than depakote for performance anxiety.

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So can Depakote help with anxiety? The conclusion

You do not have to let anxiety control you and prevent you from doing the things you love (which, if you’re here on this website, I assume is performing for an audience). Or perhaps getting jittery has been affecting your professional or personal life.

Medications like Depakote can provide a much-needed relief from physical anxiety symptoms so you can get through what you need to do. But Depakote, or any other drug, will never be the solution you’re really looking for, which is to not be fearful about performing in front of an audience in the first place.

To overcome performance anxiety in the long term, consider natural alternatives like the ones we list here, or try a natural supplement like PerformZen.

In the meantime, If you are considering depakote as a quick-fix for your anxiety symptoms, be sure to consult with your doctor first to make sure it is the right solution for you.

Take a look at our other solution articles:

PerformZen Performance Anxiety Supplement Review
Does a Stage Fright Pill Exist?
How famous athletes handle pressure
Bisoprolol for Anxiety
The best Performance Anxiety & Stage Fright books to help you with your fears
Atenolol for Anxiety - what you need to know

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PerformanceAnxiety.com Owner & Lead Writer

Anita is the owner and lead writer for PerformanceAnxiety.com. A seasoned musician and public speaker herself, she is no stranger to the very real fear and anxiety that can strike right before a high-pressure situation. That's why Anita is passionate about writing content that helps people learn about and overcome their anxieties & social fears so that they can perform at their best when it counts and live anxiety-free lives.