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  • Title: [Valproate in the treatment of bipolar disorder].
    Author: Rzewuska M.
    Journal: Psychiatr Pol; 2002; 36(2):239-57. PubMed ID: 12043042.
    Abstract:
    The paper presents the views on the use of valproate and its' derivatives in the treatment of mania and in the prophylactics of recurring bipolar affective disorder. The anti manic use of valproate has been confirmed in about half of those treated. Monotherapy of manic states with valproate brings about good results less frequently than with the use of lithium or neuroleptics. However in the treatment of mania, valproate is suggested equally frequent as lithium and carbamazepine, especially in the USA. This particularly concerns those ill in nonacute mania, mixed manic-depressive states, rapid cycling of manic as well as depressive phases--in these cases the results of treatment with valproate are best. Also in those where treatment with lithium proved ineffective, the addition of valproate can be of benefit. Valproate is also useful in the combined treatment with a neuroleptic. In the prevention of recurrence of bipolar affective disorder, the use of valproate seem to be not only equally effective as lithium, but also beneficial due to its' better tolerance. For the final outcome of the effectiveness of valproate in inhibiting recurrence, a study which would last longer than one year, would appear necessary. Further studies are also necessary in order to confirm the effectiveness of valproate in schizoaffective psychoses, manic patients addicted to medications or alcohol, organic disorders of the CNS, or the elderly patients. The more precise description of doses and the therapeutic concentration of the drug in the bloodstream in correlation with its' anti-manic and anti-recurrence action, seems to be necessary.
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