ATLANTA – Valproate appears to have a beneficial effect on the manic symptoms of child and adolescent patients with bipolar disorder, but no large scale double-blind, placebo-controlled trials have tested the anticonvulsant in young people.
A search for clinical studies of valproate in children and adolescents with bipolar disorder published from 1990 to 2003 identified nine studies, Lee S. Cohen, M.D., reported at the American Psychiatric Association's Institute on Psychiatric Services.
Of 128 patients in the metaanalysis, 92 (72%) had a positive response to valproate on one of several structured assessment scales. None of the patients had epilepsy.
In three studies that reported the effectiveness of valproate on a manic rating scale (Young Mania Rating Scale or the Modified Mania Rating Scale), 63 (65%) of 97 patients had more than 50% reduction in symptoms when valproate was part of the treatment regimen, noted Dr. Cohen of Columbia University, New York.
Some of the studies used valproate (Depacon); others used divalproex (Depakote) or valproic acid (Depakene).
In five studies that reported the blood serum level of valproate, 95 patients had an average concentration of 87 mcg/mL, although the mean dose varied between the studies because of differences in age. The metaanalysis, presented during a poster session, was funded by Abbott Laboratories, which manufactures different types of valproate (Depakote, Depakene, and Depacon).