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Valproate use in the older manic patient
B H McFarland1, M R Miller, A A Straumfjord
1Department of Psychiatry, Oregon Health Sciences University, Portland 97201.
The Journal of Clinical Psychiatry
|November 1, 1990
Summary
Valproate, an add-on treatment for affective disorders like bipolar disorder in older adults, showed significant improvement in most patients. This study indicates valproate is a safe option for elderly individuals with complex medical histories.
Area of Science:
- Geriatric Psychiatry
- Pharmacology
Background:
- Older adults with chronic affective disorders often have treatment-resistant conditions.
- Conventional treatments for bipolar disorder and related conditions may be ineffective or contraindicated in elderly patients.
Purpose of the Study:
- To evaluate the efficacy and safety of valproate as an adjunctive therapy in older state hospital patients with long-standing affective disorders.
Main Methods:
- A case series of seven elderly patients (mean age 66) with affective disorders, primarily bipolar disorder, was analyzed.
- Patients received valproate as an addition to their existing conventional medications after failing multiple prior treatments.
- Improvements were assessed after one month of adjunctive valproate treatment.
Main Results:
- Valproate demonstrated marked improvement in 3 patients, moderate in 2, and minimal in 1.
- Global Assessment Scale scores increased by an average of 29 points (p = .01).
- The treatment was found to be safe in this population, including those with multiple comorbidities.
Conclusions:
- Adjunctive valproate therapy can be effective in improving symptoms of affective disorders in older, treatment-resistant patients.
- Valproate appears to be a safe treatment option for elderly individuals with complex medical conditions.