4- Divalproex

Brady KT, Myrick H, Henderson S, et al The use of divalproex in alcohol relapse prevention a pilot study. Drug Alcohol Depend 67 323-330, 2002... [Pg.42]

Reoux JP, Saxon AJ, Malte CA, et al Divalproex sodium in alcohol withdrawal a randomized douhle-hlind placeho-controlled clinical trial. Alcohol Clin Exp Res 25 1324-1329,2001... [Pg.52]

The use of divalproex in benzodiazepine withdrawal has also become a common clinical strategy. It is usually started in doses of 500—1,000 mg in two or three divided doses daily and increased to achieve serum levels of 50—120 pg/mL. Some protocols recommend a loading dose of 20 mg/kg. [Pg.135]

Bowden CL, Calabrese JR, McElroy SL, et al (2000). A randomised, placebo-controlled 12-month trial of divalproex and lithium in treatment of outpatients with bipolar I disorder. Arch Gen Psychiatry 57, 481—9. [Pg.76]

Keck PE, Nabulsi AA, Taylor JL, et al (1996b). A pharmacoeconomic model of divalproex vs. lithium in the acute and prophylactic treatment of bipolar I disorder. J Clin Psychiatry 57> 213-22. [Pg.76]

Electroconvulsive therapy (ECT) is the application of prescribed electrical impulses to the brain for the treatment of severe depression, mixed states, psychotic depression, and treatment-refractory mania in patients who are at high risk of suicide. It also may be used in pregnant women who cannot take carbamazepine, lithium, or divalproex. [Pg.590]

Pharmacotherapy is the cornerstone of acute and maintenance treatment of bipolar disorder. Mood-stabilizing drugs are the usual first-choice treatments and include lithium, divalproex, carbamazepine, and lamotrigine. Atypical antipsychotics other than clozapine are also approved for treatment of acute mania. Lithium, lamotrigine, olanzapine, and aripiprazole are approved for maintenance therapy. Drugs used with less research support and without Food and Drug Administration (FDA) approval include topiramate and oxcarbazepine. Benzodiazepines are used adjunctively for mania. [Pg.592]

Divalproex sodium Depakote Enteric-coated, 750-3000 mg/day (20-60 mg/kg Monotherapy or in... [Pg.593]

Depakote ER Extended-release tablet Extended release divalproex may and for maintenance... [Pg.593]

Valproic acid Depakene, Capsules 250 mg A loading dose of divalproex ... [Pg.593]

Lithium Carbamazepine Oxcarbazepine Divalproex (DVPX) Sodium/Valproic Acid (VPA) Lamotrigine... [Pg.595]

Divalproex sodium is comprised of sodium valproate and valproic acid. The delayed-release and extended-release formulations are converted in the small intestine into valproic add, which is the systemically absorbed form. It was developed as an antiepileptic drug, but also has efficacy for mood stabilization and migraine headaches. It is FDA-approved for the treatment of the manic phase of bipolar disorder. It is generally equal in efficacy to lithium and some other drugs for bipolar mania. It has particular utility in bipolar disorder patients with rapid cycling, mixed mood features, and substance abuse comorbidity. Although not FDA-approved for relapse prevention, studies support this use, and it is widely prescribed for maintenance therapy. Divalproex can be used as monotherapy or in combination with lithium or an antipsychotic drug.31... [Pg.597]

Mechanism of Action The mechanism of action of divalproex is not well understood. It is known to affect ion transport and enhances the activity of y-aminobutyric acid. Like lithium, it also has possible neuroprotective effects through enhancement of brain-derived neurotrophic factor.31... [Pg.597]

Conversely, the metabolism of divalproex can be increased by enzyme-inducing drugs such as carbamazepine and phenytoin, while divalproex may simultaneously slow metabolism of the other agents.35... [Pg.599]

Lamotrigine is effective for the maintenance treatment of bipolar disorder. It is more effective for depression relapse prevention than for mania relapse. Its primary limitation as an acute treatment is the time required for titration to an effective dosage. In addition to maintenance monotherapy, it is sometimes used in combination with lithium or divalproex, although combination with divalproex increases the risk of rash, and lamotrigine dosage adjustment is required.37... [Pg.600]

Vigilance for drug-drug interactions is required because of the greater number of medications prescribed to elderly patients and enhanced sensitivity to adverse effects. Pharmacokinetic interactions include metabolic enzyme induction or inhibition and protein binding displacement interactions (e.g., divalproex and warfarin). Pharmacodynamic interactions include additive sedation and cognitive toxicity, which increases risk of falls and other impairments. [Pg.602]

Baetz, M., Bowen, R. C. Efficacy of divalproex sodium in patients with panic disorder and mood instability who have not responded to conventional therapy. Can. J. Psych. 43 73-77,1998. [Pg.908]

Clark, R. D., Canive, J. M., Calais, L. A. et al. Divalproex in posttraumatic stress disorder an open-label clinical trial. /. Trauma Stress 12 395-401,1999. [Pg.908]

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