title: Valproate use in the older manic patient.
abstract: The authors present a case series of seven older (mean age = 66 years) state hospital patients treated with valproate as an adjunct to conventional medications. The patients had had affective disorder (chiefly bipolar disorder) for an average of 31 years. Most had been hospitalized at the state hospital for several years. Previous unsuccessful treatments had included lithium, carbamazepine, antipsychotics, benzodiazepines, and antidepressants and electroconvulsive therapy in one patient. After 1 month of adjunctive treatment, valproate led to marked improvement in three patients, moderate improvement in two, minimal improvement in one, and no change in one patient with delusional depression. Global Assessment Scale scores increased over baseline an average of 29 points (p = .01). Valproate proved to be safe in these older individuals, many of whom had several medical conditions.
authors.affiliation: Department of Psychiatry, Oregon Health Sciences University, Portland 97201.
authors.forename: B H
authors.initials: BH
authors.lastname: McFarland
authors.forename: M R
authors.initials: MR
authors.lastname: Miller
authors.forename: A A
authors.initials: AA
authors.lastname: Straumfjord
mesh_terms: D000367:Age Factors; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology; D003131:Combined Modality Therapy; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D004565:Electroconvulsive Therapy; D005260:Female; D006778:Hospitals, Psychiatric; D006783:Hospitals, State; D006801:Humans; D007326:Institutionalization; D008094:Lithium / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D014150:Antipsychotic Agents; D014635:Valproic Acid; D008094:Lithium