Harvard Mental Health Letter

In Brief: Divalproex is not effective for children with bipolar disorder

In Brief

Divalproex is not effective for children with bipolar disorder

Anticonvulsant drugs are sometimes used to treat adult patients with bipolar disorder — and may offer an effective alternative to lithium treatment. But the first randomized, double-blind, controlled trial in children and adolescents found that the anticonvulsant divalproex (Depakote) performed no better than a placebo in young patients.

In this industry-sponsored study, investigators recruited 150 patients (ages 10 to 17) from several U.S. medical centers, and randomly assigned them to 28 days of treatment with extended-release divalproex or to a placebo. All were diagnosed with bipolar disorder type 1, characterized mainly by manic or mixed (manic and depressive) episodes.

At the end of the study, the drug proved no better than placebo at improving symptoms, as measured by changes in scores on the Young Mania Rating Scale. Investigators reported that 16% of patients taking divalproex achieved remission during the study, for example, compared with 19% of patients taking placebo. Response rates (as indicated by a reduction in symptoms of at least 50%) were nearly identical.

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