It came up in a Facebook conversation yesterday that a woman with PCOS had been prescribed Depakote (valproic acid) and her PCOS became worse.
It is important to know that this medication, commonly administered for the treatment of bipolar disorder and epilepsy, has actually been reported in several research studies to worsen laboratory values and symptoms of PCOS (see references below).
There is speculation that this is partially due to the fact that carnitine levels drop in the presence of Depakote.
The good news is, carnitine is available as an over the counter supplement, and research has suggested that taking acetyl-l-carnitine supplements while on valproic acid is beneficial to help minimize these side effects. The dose that has been reported/suggested is 4 grams per day.
Even though the research isn't as strong for other psych meds that have been correlated with weight gain, it's in my tool box to recommend to anyone who has noticed their symptoms worsen after starting medications in this category (psych and nervous system medications), to use the carnitine supplements.
I have written in other places that I believe it should be standard protocol when prescribing Depakote, to also prescribe carnitine. I hope, at least in practices where women with PCOS are part of the specialty, that this can become part of the treatment plan. It's an easy tool with a lot of potential.
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