Q: My sister has been on treatment for depression for the last 10 years. I don't know her complete medical history and what medicines has she been taking for so many years. Right now she is on Multizine Plus and Desval ER 750 mg. She has to take one tablet every night. What is she being treated for? What are the side effects of these medicines, if used for long term? Does she have to take these medicines for life long? She also has thyroid problem & takes Eltroxin in the morning. She is overweight and weighs 100 kg. She is married and has a 7 year-old son and twin daughters aged 5.5 years. Please advise.

A:Desval ER is the brand name. The name of the medicine is divalproex (valproic acid). It is used principally in the treatment of epilepsy. It is also used in some specific cases of psychiatric diseases i.e. in the treatment of acute manic episodes of bipolar disorder. It is not a first line antidepressant. The side effects of Desval ER are: stomach and central nervous system disturbances, skin and endocrine effects, increased appetite, weight gain, menstrual irregularity, cessation of menstrual cycle, blood disorders, bone marrow suppression, acne, hair loss, hirsutism (musculinisation of females), injury to liver or pancreas, etc. Multizine Plus does not appear on the national or international data bank of quality brands. General statement on selection of brands: There are scores, sometimes hundreds, of brands of the same medicine. Against about 300 pharmaceutical manufacturers in western countries like Britain, there are over 20,000 producers in India that market more than 60,000 brands. Most manufacturers do not have quality testing laboratories. Hence selection of brands is important. Many companies give incentives to prescribers to patronise their products. Patients should check the reputation of manufacturers before consuming medicines. Eltroxin (thyroxin) is quite appropriate in the treatment of hypothyroidism and should be continued.