Authors: Pope HG, et al.
Title: Valproate in the treatment of acute mania.
Reference: Arch Gen Psychiatry 1991;48:62-8.
Purpose: To determine the efficacy of valproate versus placebo in alleviating acute manic symptoms in bipolar patients who had previously failed to respond to, or to tolerate, lithium.
Study design: A placebo-controlled, double-blinded study.
Follow up: 7–21 days.
Patients: 36 patients (17 valproate and 19 placebo).
Treatment: Valproate adjusted to a serum level of 50–100 mg/L.
Results: Valproate was superior to placebo in alleviating the manic symptoms of patients. There was a 54% median decrease in YMRS score with valproate compared with a 5% median decrease with placebo. Substantial antimanic effects were observed within 1–4 days of valproate use. Adverse effects were not significantly different between the two groups.