Oxcarbazepine Divalproex

Lithium Carbamazepine Oxcarbazepine Divalproex (DVPX) Sodium/Valproic Acid (VPA) Lamotrigine... 

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. 

Oxcarbazepine (1000-2400 mg/day) and divalproex sodium (750-2000 mg/day) have been compared in a 12 week, randomized, double-blind pilot study in 60 patients with acute mania [218 ]. ITie median time to symptomatic remission of and the relapse rate did not differ. There were 22 adverse events in those who took oxcarbazepine group compared with 56 in those who took divalproex. The most common adverse events with oxcarbazepine were nausea (n = 5), dizziness (3), vomiting (4), sedation (3), and dyspepsia (3). 

Kakkar AK, Rehan HS, Unni KE, Gupta NK, Chopra D, Kataria D. Comparative efficacy and safety of oxcarbazepine versus divalproex sodium in the treatment of acute mania a pilot study. Eur Psychiatry 2009 24(3) 178-82. 

---