Valproate and Carbamazepine in the Treatment of Panic and Posttraumatic Stress Disorders, Withdrawal States, and Behavioral Dyscontrol Syndromes

Keck, Paul E.; McElroy, Susan L.; Friedman, Loren

doi:10.1097/00004714-199202001-00006

Cited by 118 publications

(56 citation statements)

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“…These results suggest that divalproex sodium may be a useful adjunctive pharmacologic agent for managing patients with anger associated with PTSD who receive psychotherapy. These preliminary findings support those of other studies [17][18][19][20] that have demonstrated improvement in PTSD symptoms during open-label treatment with divalproex sodium across diverse populations of PTSD patients.…”

Section: Discussionsupporting

confidence: 89%

“…11,14 Anticonvulsant mood stabilizers have received increasing attention as alternative remedies for PTSD-related symptoms. Notably, carbamazepine has been associated with improvement in flashbacks, nightmares, and reexperiencing (ie, intrusive thoughts), [15][16][17] and divalproex sodium has been reported to improve reexperiencing, hyperarousal/hyperreactivity, avoidance, and anger/ aggression. [17][18][19][20] Data from open trials suggest a role for other anticonvulsants, such as lamotrigine 21 or topiramate.…”

Section: Introductionmentioning

confidence: 99%

“…Notably, carbamazepine has been associated with improvement in flashbacks, nightmares, and reexperiencing (ie, intrusive thoughts), [15][16][17] and divalproex sodium has been reported to improve reexperiencing, hyperarousal/hyperreactivity, avoidance, and anger/ aggression. [17][18][19][20] Data from open trials suggest a role for other anticonvulsants, such as lamotrigine 21 or topiramate. 22 Because most reports have focused on combat-related PTSD in male military veterans, the generalizability of the findings to PTSD in civilian populations has not yet been studied extensively.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

An Open-Label Pilot Study of Divalproex Sodium for Posttraumatic Stress Disorder Related to Childhood Abuse

Goldberg

Cloitre

Whiteside

et al. 2003

Current Therapeutic Research

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Background: Few effective pharmacotherapeutic strategies have been established for the treatment of symptoms associated with posttraumatic stress disorder (PTSD). Preliminary evidence supports the efficacy of serotonergic agents and anticonvulsants, such as divalproex sodium, for the treatment of PTSD symptoms, particularly in military populations.Objective: The aim of this study was to obtain pilot data on the use of divalproex sodium for the treatment of PTSD among adult civilian outpatients with a history of childhood physical and/or sexual abuse.Methods: Outpatients with a primary psychiatric diagnosis of PTSD received open-label, flexibly dosed divalproex sodium as adjuvant therapy or monotherapy for 8 weeks. Overall and subcluster PTSD features, as well as affective symptoms and clinical global improvement, were monitored using standardized assessment scales.Results: A total of 7 patients (5 women, 2 men; mean age, 44.1 years [range, 29-57 years]) were enrolled. At a mean (SD) peak dosage of 1500 (661) mg/d, significant improvement occurred in overall PTSD symptom severity (P Ͻ 0.02) and in the diagnostic subclusters of hyperarousal and avoidance (P Ͻ 0.02 for both). Depressive symptoms also were significantly improved from baseline (P Ͻ 0.02). Divalproex sodium was well tolerated, except in 1 patient who prematurely discontinued treatment due to cognitive adverse events.Conclusions: These provisional findings support the possible utility of divalproex sodium therapy for adult outpatients with PTSD related to physical and/ or sexual abuse during childhood. Controlled trials with larger sample sizes powered to show safety and efficacy are needed to substantiate these initial

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An Open-Label Pilot Study of Divalproex Sodium for Posttraumatic Stress Disorder Related to Childhood Abuse

Goldberg

Cloitre

Whiteside

et al. 2003

Current Therapeutic Research

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“…VPA has both anticonvulsant and anti-kindling properties, and acts to enhance levels of GABA suppressing glutamate function via NMDA receptors [73] [74].…”

Section: Valproic Acidmentioning

confidence: 99%

The Use of Antiepileptic Drugs in Acute Neuropsychiatric Conditions: Focus on Traumatic Brain Injury, Pain, and Alcohol Withdrawal

Nejad

Chuang²,

Hirschberg³

et al. 2014

IJCM

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Antiepileptic drugs (AEDs), have demonstrated efficacy treating a number of acute conditions, encompassing a broad range of symptoms and syndromes, in addition to being first-line treatment for epilepsy. Clinically, since their inception, AEDs have been used off-label for acute and chronic medical conditions, both as primary and as adjuvant therapies. In this review, we describe the observed clinical effectiveness of AEDs across a set of commonly encountered acute conditions in the general hospital: traumatic brain injury, pain, alcohol withdrawal. In describing the individual benefits and usages of specific agents, the applicability of these agents to other common neuropsychiatric conditions may be further explored.

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“…Valproic acid is an antiepileptic whose effectiveness in various mood and anxiety disorders has been shown [1][2][3]. Valproic acid exerts its antiepileptic effects by increasing the activity of gamma-aminobutyric acid (GABA) in the brain [4,5].…”

Section: Introductionmentioning

confidence: 99%

Treatment response to valproate in case with generalized anxiety disorder resistant to antidepressants

Vayısoğlu

2017

Psychiatry and Clinical Psychopharmacology

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Objective: Pharmacological treatment of anxiety disorders is an active research field and Selective Serotonin Reuptake Inhibitors (SSRIs) are considered to be the first line of drugs in this treatment. In cases resistant to SSRI, in addition to serotonin-noradrenaline reuptake inhibitors (SNRIs), antiepileptic drugs that have anxiolytic activity by increasing the efficiency of gamma-aminobutyric acid (GABA) such as valproate can be used. Methods: Observational case report. Results: The author describes the use of valproic acid in the treatment of a patient who had resistant anxiety symptoms despite the treatment with SSRIs and SNRIs in appropriate doses for appropriate time. Conclusions:The favorable response obtained with the use of valproate outside of its classical indications in our patient who was resistant to antidepressants indicates that valproate should be considered in anxiety disorders. ARTICLE HISTORY

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Valproate and Carbamazepine in the Treatment of Panic and Posttraumatic Stress Disorders, Withdrawal States, and Behavioral Dyscontrol Syndromes

Cited by 118 publications

References 0 publications

An Open-Label Pilot Study of Divalproex Sodium for Posttraumatic Stress Disorder Related to Childhood Abuse

An Open-Label Pilot Study of Divalproex Sodium for Posttraumatic Stress Disorder Related to Childhood Abuse

The Use of Antiepileptic Drugs in Acute Neuropsychiatric Conditions: Focus on Traumatic Brain Injury, Pain, and Alcohol Withdrawal

Treatment response to valproate in case with generalized anxiety disorder resistant to antidepressants

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