title: Divalproex as a calmative adjunct for aggressive schizophrenic patients.
abstract: BACKGROUND
  Selection of appropriate pharmacotherapy for psychotic patients who exhibit dangerousness is an important issue. Divalproex is a fast-acting agent which appears to be safe and effective in such circumstances. The objective of the following inpatient study was to investigate divalproex as a pharmaceutical adjunct in treating agitated and/or violent, psychotic schizophrenic subjects.
  
  
  METHODS
  For the purpose of comparison, 147 hospitalized patients were separated into violent (n = 60) and non-violent (n = 87) groups. In addition to antipsychotic drugs given to all subjects, divalproex was preferentially prescribed for the more dangerous patients (n = 40). The clinical status of demographics and parameters related to dangerousness in all participants was assessed to document differences during these admissions and for rehospitalization over one year.
  
  
  RESULTS
  Divalproex was well tolerated; however, one individual developed a transient granulocytopenia. Its use in agitated and/or violent psychotic persons appears to have included a calmer, less dangerous hospital course, like that observed among their less disruptive counterparts.
  
  
  CONCLUSIONS
  Divalproex seemed to have been helpful in this study at facilitating a more routine hospital course for agitated psychotic patients, similar to that of less overtly disturbed individuals. No significant adverse events were observed. The validity of this study is limited by its retrospective, uncontrolled nature.
authors.affiliation: University of Louisville School of Medicine, Department of Psychiatry and Behavioral Sciences, USA.
authors.forename: Irfan
authors.initials: I
authors.lastname: Afaq
authors.forename: Jawad
authors.initials: J
authors.lastname: Riaz
authors.forename: Karim
authors.initials: K
authors.lastname: Sedky
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Chung
authors.forename: Yelena
authors.initials: Y
authors.lastname: Vanina
authors.forename: Rif
authors.initials: R
authors.lastname: el-Mallakh
authors.forename: Steven
authors.initials: S
authors.lastname: Lippmann
mesh_terms: D000328:Adult; D000374:Aggression / Q000187:drug effects*; D014150:Antipsychotic Agents / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy*; D012016:Reference Values; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014635:Valproic Acid / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D014150:Antipsychotic Agents; D014635:Valproic Acid