Divalproex sodium in the treatment of pediatric psychiatric disorders.
Divalproex sodium is an anticonvulsant that is used extensively in adults with indications for epilepsy, acute mania and migraine prophylaxis. It has been used in children and adolescents as a first-line agent for mania in bipolar disorder. Its efficacy as a mood stabilizer has been established, and there have been studies outlining its efficacy as an agent effective in the treatment of conduct disorder, disruptive behavior disorders, aggression and explosive disorder. Longer-acting formulations are now available that cause less gastrointestinal side effects and can also be taken once a day, thus potentially increasing adherence, an important factor in this patient population. Future directions would include developing a more potent valproic acid formulation with fewer side effects, completing randomized controlled trials to establish the efficacy of divalproex sodium in various other pediatric psychiatric disorders, establishing the relative efficacy of the compound in head-to-head comparisons with other mood stabilizers, examining systematically the value of the compound in multimodal pediatric psychiatric treatment packages, and complete effectiveness trials that demonstrate the short- and long-term effectiveness of the compound in the real world of clinicians. In this drug profile, divalproex sodium and its uses in the pediatric population for psychiatric conditions are reviewed.
Rana
Manasi
M
Division of Child Psychiatry and Child Development, Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, 401 Quarry Road, Stanford, CA 94305 5719, USA. mrana@stanford.edu
Khanzode
Leena
L
Karnik
Niranjan
N
Saxena
Kirti
K
Chang
Kiki
K
Steiner
Hans
H
D000293:Adolescent; D014150:Antipsychotic Agents / Q000737:chemistry / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000188:drug therapy / Q000378:metabolism; D001321:Autistic Disorder / Q000188:drug therapy; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism; D002648:Child; D004339:Drug Compounding; D005104:Expert Testimony; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism; D010372:Pediatrics; D014635:Valproic Acid / Q000737:chemistry / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*
D014150:Antipsychotic Agents; D014635:Valproic Acid