From the Guidelines
Depakote (valproate) can be an effective treatment for behavioral disorders, particularly in patients with bipolar disorder, and is often used off-label for managing challenging behaviors in various conditions. The use of Depakote for behavioral disorders is supported by studies such as 1, which discusses the efficacy of valproate in treating juvenile mania. Key points to consider when using Depakote for behavioral disorders include:
- Starting dose: 250-500mg daily, gradually increasing to 750-1500mg daily divided into 2-3 doses
- Adjustments based on response and blood levels (therapeutic range: 50-100 μg/mL)
- Treatment duration: varies from weeks to years depending on the condition and response
- Common side effects: sedation, gastrointestinal upset, tremor, and weight gain
- Serious concerns: liver dysfunction, pancreatitis, and thrombocytopenia
- Regular monitoring of blood levels, liver function, and complete blood counts is essential, as noted in 1 It is essential to combine Depakote with behavioral interventions for optimal results, rather than using it alone. In elderly patients or those with liver issues, lower doses are recommended, and the medication should be taken with food to minimize stomach upset, as suggested by 1. Overall, Depakote can be a valuable treatment option for managing behavioral disorders, but its use should be carefully monitored and adjusted based on individual patient needs and response.
From the Research
Use of Depakote (Valproate) for Behavioral Disorders
- Depakote (valproate) is used in the treatment of bipolar disorder, which is characterized by recurrent manic, depressive, or mixed episodes 2.
- The combination of aripiprazole and valproate seems to be particularly promising in the treatment of patients with comorbidities such as anxiety and drug abuse, obsessive-compulsive disorder, and bipolar disorder, as well as in mixed depressive disorder 2.
- Valproate is an anticonvulsant drug that has been shown to be effective in acute mania and is frequently used in maintenance treatment of bipolar disorder 3.
- The use of valproate in the maintenance treatment of bipolar disorder has been found to be effective in preventing or attenuating further episodes of bipolar disorder, including its effectiveness in rapid cycling disorder 3, 4.
- Valproate has been found to be associated with fewer participants dropping out of treatment for any cause when compared with placebo or lithium 3.
- The combination of lithium and valproate may be more effective than monotherapy with valproate in preventing relapse 3.
- Chronic treatment with both lithium and sodium valproate may normalize phosphoinositol cycle activity in bipolar patients 5.
- Intravenous valproate has been found to be an efficacious, safe, and well-tolerated treatment for manic episodes, and it is comparable to the oral loading regimen 6.
Efficacy and Safety of Valproate
- Valproate has been found to be effective in preventing study withdrawal due to any mood episode, but no difference in efficacy was found between valproate and lithium 3.
- Valproate has been associated with increased sedation and infection, whereas lithium was associated with more frequent diarrhoea, polyuria, increased thirst, and enuresis 3, 4.
- The use of valproate has been found to be associated with significant differences in adverse event frequencies, including tremor, weight gain, and alopecia 4.