Effectiveness of valproate on delirium and/or aggressive behavior in demented patients: A practical pilot study

This open study was designed to evaluate the efficacy of valproate as a treatment for delirium and/or aggressive behavior in patients with dementia. Of the patients who participated, nine had vascular dementia, two had Alzheimer's disease, one had Parkinson's disease and one had alcohol dependence, all meeting DSM-IH-R criteria for dementia. In these 13 patients, delirium in seven and aggressive behavior in 12 patients were the target symptoms of this study. Valproate was administered orally at a dose of 200-600 mg daily (mean 526 mg, sd=20.4) without changing the dose of the other medications. The effect of valproate on delirium and aggressive behavior was evaluated with the Delirium Rating Scale (DRS) and Gottfries-Brane-Steen Scale (GBS). The total DRS scores decreased in 6/7 patients with delirium (P < 0.05) within 2 weeks. There were significant diferences between the score variances (before and during treatment) of the three categories in the GBS scale: emotional lability (P < 0.01), irritability (P < 0.01) and restlessness (P < 0.01). These findings suggest the effectiveness of valproate treatment for delirium and/or aggressive behavior in demented patients.