Valproate in the Treatment of Acute Mania

Abstract

Objective:

To determine whether valproate is effective for the acute treatment of mania.

Data Sources:

Pertinent literature was identified through a MEDLINE search.

Study Selection:

Blinded, controlled, or other high-quality trials with adequate sample size evaluating valproate in the treatment of acute mania were selected.

Data Extraction:

Study selection for the review was based on the quality of the trial and the clinical endpoint of control of acute manic symptoms using valproate.

Data Synthesis:

Acute manic episodes in bipolar disease are disabling and dangerous. A minority of acutely manic patients either do not respond to treatment with lithium or cannot tolerate its adverse effects. Valproate is a viable but slightly less effective alternative in the patients who cannot use lithium.

Conclusions:

Combined analysis of all studies examined in this article yields a success rate of 54% for valproate in the treatment of acute mania. This efficacy rate recommends valproate as suitable alternative treatment for acutely manic patients who do not respond to lithium or cannot tolerate its adverse effects.