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Treatment of psychiatric disorders with valproate: a series of 73 cases

Published online by Cambridge University Press:  28 April 2020

S.L. Mc Elroy ,
H.G. Pope Jr ,
P.E. Keck Jr  and
J.I. Hudson
S.L. Mc Elroy*
Affiliation:
The Epidemiology Laboratory, Laboratories for Psychiatrie Research, Mailman Research Center, McLean Hospital, Belmont, MA; Harvard Medical School, Boston, MA, USA
H.G. Pope Jr
Affiliation:
The Epidemiology Laboratory, Laboratories for Psychiatrie Research, Mailman Research Center, McLean Hospital, Belmont, MA; Harvard Medical School, Boston, MA, USA
P.E. Keck Jr
Affiliation:
The Epidemiology Laboratory, Laboratories for Psychiatrie Research, Mailman Research Center, McLean Hospital, Belmont, MA; Harvard Medical School, Boston, MA, USA
J.I. Hudson
Affiliation:
The Epidemiology Laboratory, Laboratories for Psychiatrie Research, Mailman Research Center, McLean Hospital, Belmont, MA; Harvard Medical School, Boston, MA, USA
*
*Correspondence and reprints: S.L. Mc Elroy, Mc Lean Hospital, 115 Mill Street, Belmont, MA 02175, USA.
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Summary

A growing body of literature suggests that the anticonvulsant valproate may be effective in some psychiatric disorders. We evaluated 73 consecutive psychiatric patients without diagnosable neurologic disorder, and refractory to previous medications, who were treated with valproate. The drug appeared: 1) moderately to markedly effective in 59% of patients in the manic phase of bipolar or schizoaffective disorder; 2) largely ineffective in patients with major depression, schizophrenia, and other psychiatric disorders; and 3) well tolerated, with no cases of serious hepatic or hematologic toxicity. Age, sex, duration of illness, presence of psychotic symptoms, and presence of soft neurological signs or CT scan abnormalities did not predict response to valproate; however, nonspecific (nonparoxysmal) EEG abnormalities showed a slight but significant association with response.

Résumé

Résumé

Des publications de plus en plus nombreuses concernant le valproate font état de la possible efficacité de cet anticonvulsivant dans le traitement de certains troubles psychiatriques. Nous avons étudié l’efficacité du valproate de sodium sur 73 malades psychiatriques consécutifs indemnes d’affections neurologiques, et résistants aux traitements antérieurement prescrits. Ce produit s‘est révélé être: 1) d’une efficacité (allant de moyenne à marquée) chez 59% des patients bipolaires ou schizoaffectifs lors de la phase maniaque; 2) d’une inefficacité totale chez les patients présentant une dépression majeure, une schizophrénie ainsi que d’autres troubles psychiatriques; enfin 3) d’une bonne tolérance sans que l’on puisse observer de cas de toxicité hépatique ou hématologique importante.

L’âge, le sexe et la durée du traitement, la présence de symptômes psychotiques, de signes neurologiques fonctionnels ou d’anomalies au scanner ne permettent pas de prédire la réponse au valproate; cependant les anomalies EEG non-spécifiques (non-paroxystiques) sont corrélées à la réponse, faiblement mais de façon significative.

Keywords

valproatebipolar disorderschizoaffective disordermanic syndromevalproatedésordre bipolairedésordre schizoaffectifsyndrome maniaque
Type
Original article
Information
Psychiatry and Psychobiology , Volume 3 , Issue 2 , 1988 , pp. 81 - 85
Copyright
Copyright © European Psychiatric Association 1988

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References

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