Valproate and lithium in acute mania Authors: Bowden CL, et al.; for the Depakote Mania Study Group. Title: Efficacy of divalproez vs lithium and placebo in the treatment of mania. Reference:JAMA 1994;271:918-24. Purpose: To compare the effectiveness of valproate with that of lithium and placebo in patients with acute mania. Study design: Randomized, double-blinded, parallel-group study. Follow up: 21 days. Patients: 176 patients (68 valproate, 35 lithium, and 73 placebo) Treatment: Divalproex to target concentration of 1,041 µmol/L (150 mcg/mL) and lithium to target of 1.5 mmol/L (mEq/L), as tolerated. Results: Both valproate and lithium were superior to placebo in reducing the manic symptoms of patients. Response rates (at least 50% improvement) were significantly higher for valproate (48%) and lithium (49%) than placebo (25%). Valproate was as effective in patients with rapid-cycling mania as in other patients.
