title: Tolerability of divalproex sodium in elderly psychiatric patients with mixed diagnoses.
abstract: This study addresses the tolerability of divalproex sodium in elderly psychiatric inpatients with various Axis I diagnoses, using structured assessments. A chart review for a 7-month period on a geropsychiatry inpatient unit identified 13 patients who had been treated with divalproex sodium. All 13 patients received standardized ratings on the Cohen-Mansfield Agitation Inventory (CMAI), Brief Psychiatric Rating Scale (BPRS), Rating Scale for Side Effects (RSSE), and Mini-Mental State Examination (MMSE) on admission and discharge, which were compared using paired t-tests for 12 of the 13 patients. The thirteenth patient was withdrawn from valproate prior to discharge after developing a delirium thought to be secondary to a divalproex-phenytoin interaction. All of the remaining 12 patients tolerated divalproex sodium well with no significant change in MMSE scores (P = .486), CMAI scores (P = .0546), or RSSE scores (P = .124). The change in BPRS score was found to be significant (P = .004). Based on the present study and previously reported case series, divalproex sodium appears to be well tolerated in an elderly psychiatric population.
authors.affiliation: Department of Psychiatry, Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: L J
authors.initials: LJ
authors.lastname: Puryear
authors.forename: M E
authors.initials: ME
authors.lastname: Kunik
authors.forename: R
authors.initials: R
authors.lastname: Workman
mesh_terms: D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004361:Drug Tolerance; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000523:psychology; D008875:Middle Aged; D012559:Schizophrenia / Q000188:drug therapy*; D014635:Valproic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid