title: Single-dose intravenous valproate in acute mania.
abstract: 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.
authors.affiliation: Stanley Research Center, Ministry of Health Mental Health Center, Ben Gurion University of the Negev, Beersheva, Israel.
authors.forename: Katrina
authors.initials: K
authors.lastname: Phrolov
authors.forename: Julia
authors.initials: J
authors.lastname: Applebaum
authors.forename: Joseph
authors.initials: J
authors.lastname: Levine
authors.forename: Hanoch
authors.initials: H
authors.lastname: Miodovnick
authors.forename: R H
authors.initials: RH
authors.lastname: Belmaker
mesh_terms: 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*
chemical_list: D018692:Antimanic Agents; D014635:Valproic Acid