Abstract | BACKGROUND: METHOD: We reviewed the charts of 63 patients diagnosed as bipolar I (35 patients), bipolar II (23 patients), or schizoaffective, bipolar type (5 patients). Twelve patients who appeared to have recurrent unipolar depression had a retrospectively recognized history of "covert cycling," with brief periods of socially acceptable hypomania occurring between depressive episodes. Prior to treatment with divalproex, 45 patients had been classified as treatment failures with lithium, 29 patients had been classified as treatment failures with carbamazepine, and 35 patients had also failed on a combination of lithium and carbamazepine. Divalproex was given to these patients and titrated to achieve blood levels in the range of 50 to 100 mg/L. RESULTS: Forty-seven (75%) of the 63 patients responded positively to the addition of divalproex to their regimens. Of 45 patients who had failed to respond to lithium, 38 (84%) responded when divalproex was added. Of 29 patients who had failed to respond to carbamazepine, 20 (69%) responded when divalproex was added. Of 26 rapid-cycling patients, 21 (81%) responded to the addition of divalproex. Side effects required drug withdrawal in 9 patients (14%). CONCLUSION:
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Authors | M R Schaff, J Fawcett, J M Zajecka |
Journal | The Journal of clinical psychiatry
(J Clin Psychiatry)
Vol. 54
Issue 10
Pg. 380-4
(Oct 1993)
ISSN: 0160-6689 [Print] United States |
PMID | 8262880
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Carbamazepine
- Valproic Acid
- Lithium
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Topics |
- Adult
- Aged
- Bipolar Disorder
(drug therapy, psychology)
- Carbamazepine
(therapeutic use)
- Depressive Disorder
(drug therapy, psychology)
- Drug Therapy, Combination
- Female
- Humans
- Lithium
(therapeutic use)
- Male
- Middle Aged
- Psychotic Disorders
(drug therapy, psychology)
- Recurrence
- Retrospective Studies
- Treatment Outcome
- Valproic Acid
(administration & dosage, therapeutic use)
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