Naturalistic experience with the use of divalproex sodium on an in‐patient unit for adolescent psychiatric patients

Abstract

This paper focuses on the importance of data collected not only from controlled clinical trials, but also from naturalistic treatment experience. In particular we examine the use of divalproex sodium either as monotherapy or as part of combined therapy on an in-patient ward for adolescents aged 13-18 years. All admissions in which divalproex sodium use was attempted (n=36) were analysed over a 1-year period. The most common use was in patients with a mixed-presentation bipolar disorder (n=16), followed by patients with major depression (n=7), mania (n=4) or psychoses not otherwise specified (n=4). Divalproex sodium use was evaluated in the control of mania, psychosis, agitation, mood swings, aggression and/or anxiety. Overall, the use of divalproex sodium was associated with a marked improvement along all psychopathological variables in the vast majority of patients. Few side-effects or medical complications were noted. We believe that divalproex sodium is a potentially useful drug in adolescent patients with varying forms of psychopathology.

Divalproex Sodium for the Treatment of PTSD and Conduct Disordered Youth: A Pilot Randomized Controlled Clinical Trial

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Risperidone and Divalproex Differentially Engage the Fronto-Striato-Temporal Circuitry in Pediatric Mania: A Pharmacological Functional Magnetic Resonance Imaging Study

“…3, 7 Findings from open trials in pediatric mania that showed that divalproex is useful. 2, 3, 8, 9 are in contrast to those from the double-blind placebo-controlled trial of divalproex extended release showing no benefit relative to placebo. 10 A mechanistic understanding of how these medications impact brain function may offer further insight into how these two medications yield differential results.…”

Practitioner Review: The Treatment of Bipolar Disorder in Children and Adolescents

“…A naturalistic study of 20 445 TREATMENT OF BIPOLAR DISORDER Swedish adolescent inpatients with bipolar disorder, 16 mixed-form, showed a good response with few side effects. There was good control of manic and psychotic symptoms as well as of agitation and aggression (Deltito, Levitan, Damore, Hajal, & Zambenedetti, 1998). Some studies, however, demonstrate only a 50 % response rate to monotherapy.…”