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Valproic Acid for Treatment of Hyperactive or Mixed Delirium: Rationale and Literature Review
Yelizaveta Sher1, Anne Catherine Miller Cramer2, Andrea Ament3
1Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.
Psychosomatics
|December 18, 2015
Summary
Valproic acid (VPA) offers a potential treatment for delirium, targeting its complex pathophysiology. Further research is needed, but VPA shows promise for managing hyperactive and mixed delirium types.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Delirium is a common and serious condition in hospitals, particularly in ICUs.
- Current treatments like antipsychotics have limitations in efficacy and side effect profiles.
- Valproic acid (VPA) presents a potential alternative due to its multifaceted mechanisms of action.
Purpose of the Study:
- To explore the theoretical basis for using VPA in treating hyperactive and mixed delirium.
- To review VPA's mechanisms of action relevant to delirium pathophysiology.
- To discuss VPA's potential side effects and clinical considerations.
Main Methods:
- Review of existing literature on delirium pathophysiology.
- Analysis of VPA's known pharmacological actions.
- Theoretical extrapolation of VPA's efficacy in delirium management.
Main Results:
- VPA modulates neurotransmitters, neuroinflammation, oxidative stress, and transcription, all implicated in delirium.
- These mechanisms provide a theoretical framework for VPA's use in delirium.
Conclusions:
- VPA demonstrates potential as an effective and well-tolerated treatment for hyperactive and mixed delirium.
- Careful patient selection is crucial for VPA therapy.
- Randomized controlled trials are necessary to confirm VPA's efficacy and tolerability in delirium.
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