Divalproex treatment for youth with explosive temper and mood lability: a double-blind, placebo-controlled crossover design.
OBJECTIVE
The authors sought to replicate open-label findings showing that specific criteria for explosive temper and mood lability identify disruptive youth who improve while receiving the anticonvulsant divalproex sodium.


METHODS
Twenty outpatient children and adolescents (ages 10-18) with a disruptive behavior disorder (oppositional defiant disorder or conduct disorder) met the specific criteria for explosive temper and mood lability. They received 6 weeks of divalproex treatment and 6 weeks of placebo by random assignment. Independent evaluators blind to group assignment assessed response at the end of each phase.


RESULTS
At the end of phase 1, eight of 10 subjects had responded to divalproex; zero of 10 had responded to placebo. Of the 15 subjects who completed both phases, 12 has superior response taking divalproex.


CONCLUSIONS
This preliminary study replicates open-label findings showing that divalproex is an efficacious treatment for explosive temper and mood lability in disruptive children and adolescents.
Donovan
S J
SJ
Department of Therapeutics, Division of Epidemiology of Brain Disorders, New York State Psychiatric Institute, New York, NY 10032, USA. sd45@columbia.edu
Stewart
J W
JW
Nunes
E V
EV
Quitkin
F M
FM
Parides
M
M
Daniel
W
W
Susser
E
E
Klein
D F
DF
D000293:Adolescent; D000553:Ambulatory Care; D000927:Anticonvulsants / Q000627:therapeutic use*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D002648:Child; D015897:Comorbidity; D018592:Cross-Over Studies; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D010919:Placebos; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use*
D000927:Anticonvulsants; D010919:Placebos; D014635:Valproic Acid