Single-dose intravenous valproate in acute mania.
OBJECTIVE
High-dose loading with oral and intravenous valproate has been reported to be therapeutic in mania over 48 to 72 hours. We hypothesized that very high dose intravenous (IV) valproate might have even more rapid effects equivalent to effects in status epilepticus that occur within 20 minutes.


METHODS
Seven patients with mania (Young Mania Rating Scale score > 20) and minimal prior drug treatment were given valproate 20 mg/kg IV over 30 minutes.


RESULTS
No antimanic effects were observed during 120 minutes of observation. There were no side effects.


CONCLUSIONS
Slowly evolving biochemical changes, perhaps at the gene level, may be required for the antimanic effect of anticonvulsants.
Phrolov
Katrina
K
Stanley Research Center, Ministry of Health Mental Health Center, Ben Gurion University of the Negev, Beersheva, Israel.
Applebaum
Julia
J
Levine
Joseph
J
Miodovnick
Hanoch
H
Belmaker
R H
RH
D000208:Acute Disease; D000328:Adult; D018692:Antimanic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014635:Valproic Acid / Q000008:administration & dosage* / Q000627:therapeutic use*
D018692:Antimanic Agents; D014635:Valproic Acid