Valproate preparations for agitation in dementia.

Area of Science:

• Geriatric Medicine
• Psychiatry
• Clinical Pharmacology

Background:

• Agitation affects up to 90% of individuals with dementia, worsening caregiver burden and increasing injury risk.
• Current treatments, including valproate preparations, have questionable safety and efficacy for dementia-related agitation.

Purpose of the Study:

• To evaluate the efficacy and safety of valproate preparations in managing agitation in people with dementia.
• To assess the impact of valproate treatment on caregivers.

Main Methods:

• Systematic review and meta-analysis of randomized, placebo-controlled trials.
• Searched ALOIS database including major healthcare databases and grey literature.
• Included five studies with 430 participants, assessing agitation, cognition, function, and adverse events.

Main Results:

• Valproate showed little to no effect on agitation, with moderate to very low quality evidence.
• Increased incidence of adverse effects (sedation, GI issues, UTIs) and possibly serious adverse events (SAEs) in the valproate group.
• Cognitive function showed little effect, while physical self-maintenance possibly worsened with valproate.

Conclusions:

• Valproate preparations are likely ineffective for dementia agitation and associated with higher adverse event rates.
• Valproate therapy is not recommended for managing agitation in dementia.
• Future research should prioritize non-pharmacological interventions or safer medication alternatives.