Bipolar disorder semisodium

The availability of anticonvulsant mood stabilizers has led to comparative studies with lithium. A review of the comparative efficacy and tolerability of drug treatments for bipolar disorder included tolerability comparisons of lithium versus carbamazepine, lithium versus valproate semisodium, and lithium versus other medications (47). 

In the UK the National Institute for Clinical Excellence (NICE) has given guidance supporting the use of olanzapine and valproate semisodium in acute mania. NICE guidelines on the treatment of bipolar disorder are expected in June 2006. 

Valproic acid is the drug of first choice for prophylaxis of bipolar affective disorder in the United States, despite the lack of robust clinical trial evidence in support of this indication. But treatment with valproic acid is easy to initiate (especially compared to lithium), it is well tolerated and its use appears likely to extend if the evidence-base expands. As the semisodium salt, valproic acid is licenced for use in the treatment of acute mania unresponsive to lithium. (Note sodium valproate, see p. 420, is unlicenced for this indication.)... 

National Institute for Clinical Excellence Technology Appraisal Guidance 66. Olanzapine and valproate semisodium in the treatment of acute mania associated with bipolar 1 disorder, 2003. http //WWW. nice, org. uk/... 

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