Valproate in acute mania 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.
