Depakote Infusion for Migraine

After trying several as needed, monthly, and daily medications to try to break my cycle of chronic migraine attacks, my neurologist told me the next thing we were going to try to “reset the inflammation cycle,” was a Depakote (valproate) infusion. It's an intervention she recommends often enough that the larger hospital group included the treatment in an article she's quoted in. The article says they can schedule people within an hour to get the infusion, but, for whatever reason, my appointment was scheduled for several weeks after my neurologist put in the order.¹

What happened when I arrived?

I rolled up to the appointment early and checked in. It was at the cancer center, which is where they do infusions most often, of course, but I hadn’t expected that when I made the appointment. They led me to a recliner and brought me a warm blanket. I picked a spot with a nice view of trees out the window and settled in with my book.

What did I notice during the appointment?

There was a delay before the nurse came to see me and had me take a pregnancy test which I also didn’t know I’d have to do so I’d peed right before coming in. I made it happen. Then, a full hour after being in the chair, the IV went in and the nurse wrapped it in dinosaur-printed gauze, which cheered me up. The first hour was magnesium and fluids. After barely being able to produce enough pee for a pregnancy test an hour earlier, I had to pee three times while on the saline. “I just put half a soda bottle of fluid in you!” the nurse said when I asked if the IV was making me have to pee.

Why did I feel I was misled?

I had been told very explicitly when I made the appointment that I could drive myself there and home again, because the medication wouldn’t make me drowsy. However, the nurse said the magnesium might make me want to take a nap, and if it didn’t, the Depakote might, and if that didn’t, it might make me nauseated, at which point they’d give me Compazine and then THAT would make me drowsy. She said I could plan to nap in the chair after the infusion or they could call me an Uber. I thought this would be a two-hour in and out appointment and that I could go home and work after this, so I was not thrilled by this news.

How did my body react to the Depakote?

However, once the Depakote went in, every time the nurse checked on me, she was surprised to see me awake and alert. Maybe I’m not as sensitive to the medication as some people, which is honestly surprising since I’m generally pretty sensitive. Maybe the murder mystery I was reading kept me alert. At any rate, five hours after arriving at the building (and five pee breaks), I was disconnected and free to go.

What did the experience show me?

Looking around the room in my hours in the chair, I saw people getting chemo, cold caps on their heads to help prevent hair loss. I saw a woman getting blood. There was a very young man getting an infusion who was telling the nurse that he’d recently had to start coming to these infusion centers after “graduating” from the pediatric unit. I was appreciative of my relative health, even if the migraines are often debilitating. I was thankful I got to drive myself home, that I didn’t have to enlist a barrage of chaperones and caretakers to get the treatment I needed. I was thankful I got to hang out with my kids that afternoon and take the dogs on a walk, that I felt well enough to do so, and, when I did get drowsy, that I could put myself to bed, knowing that was probably going to be my only side effect.

Would I need another infusion for my migraine?

As she removed my IV, the nurse said, “Is this a one and done treatment for you?”

“I hope so.”

“I hope it helps,” she said.

“Me too,” I said. “Thank you.”