title: Neuropsychological effects of valproate in traumatic brain injury: a randomized trial.
abstract: OBJECTIVE
  To examine the neuropsychological side effects of valproate (VPA) given to prevent posttraumatic seizures.
  
  
  METHODS
  In a randomized, double-masked, parallel group clinical trial, we compared the seizure prevention and neuropsychological effects of 1 or 6 months of VPA to 1 week of phenytoin. We studied 279 adult subjects who were randomized within 24 hours of injury and examined with a battery of neuropsychological measures at 1, 6, and 12 months after injury. We examined drug effects cross-sectionally at 1, 6, and 12 months and longitudinally by examining differential change from 1 to 6 months and from 6 to 12 months as a function of protocol-dictated changes in treatment.
  
  
  RESULTS
  No significant adverse or beneficial neuropsychological effects of VPA were detected.
  
  
  CONCLUSIONS
  Valproate (VPA) appears to have a benign neuropsychological side effects profile, making it a cognitively safe antiepileptic drug to use for controlling established seizures or stabilizing mood. However, based on this study, VPA should not be used for prophylaxis of posttraumatic seizures because it does not prevent posttraumatic seizures, there was a trend toward more deaths in the VPA groups, and it did not have positive effects on cognition.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle 98195-6490, USA. dikmen@u.washington.edu
authors.forename: S S
authors.initials: SS
authors.lastname: Dikmen
authors.forename: J E
authors.initials: JE
authors.lastname: Machamer
authors.forename: H R
authors.initials: HR
authors.lastname: Winn
authors.forename: G D
authors.initials: GD
authors.lastname: Anderson
authors.forename: N R
authors.initials: NR
authors.lastname: Temkin
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000188:drug therapy* / Q000523:psychology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D014635:Valproic Acid