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Valproate for acute mood episodes in bipolar disorder
K Macritchie1, J R Geddes, J Scott
1Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OXON, UK, OX3 7JX. john.geddes@psych.ox.ac.uk
The Cochrane Database of Systematic Reviews
|January 22, 2003
Summary
Valproate is an effective treatment for acute mania in bipolar disorder, showing better results than placebo. While not significantly different from lithium or carbamazepine, it may be less effective than olanzapine but with fewer side effects.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Trials
Background:
- Bipolar disorder is a common, debilitating mental illness characterized by acute mood episodes.
- Effective treatments for acute bipolar episodes are crucial for patient well-being.
- Valproate is increasingly used as a mood stabilizer, alternative or adjunctive to lithium.
Purpose of the Study:
- To evaluate the efficacy and acceptability of valproate for treating acute bipolar disorder episodes.
- To compare valproate's effectiveness against placebo, other mood stabilizers, and antipsychotic medications.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) comparing valproate with other treatments.
- Searched multiple databases and contacted experts for relevant studies.
- Assessed methodological quality and extracted data on treatment response and withdrawal rates.
Main Results:
- Valproate demonstrated superior efficacy compared to placebo in treating acute mania.
- No significant differences were found between valproate and lithium or carbamazepine.
- Valproate was less effective than olanzapine but associated with less sedation and weight gain.
Conclusions:
- Valproate is an effective treatment for acute mania, supported by consistent evidence.
- Olanzapine may be more effective but carries a higher burden of side effects like sedation and weight gain.
- Further high-quality RCTs are needed to assess valproate's efficacy across all bipolar episode types.
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