Divalproex sodium reduces overall aggression in youth at high risk for bipolar disorder.
BACKGROUND
The psychopharmacology of aggression in youth is relatively unexplored, even though such maladaptive aggression manifests across many different diagnoses.


METHODS
This study was a 12-week, open-label trial with divalproex sodium (DVPX) in 24 bipolar offspring 6-18 years of age (mean age = 11.3 years; 17 boys) with mixed diagnoses of major depression, cyclothymia, attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD). The Overt Aggression Scale (OAS) was used to measure aggression in 4-week intervals. We measured serum gamma-butyric acid (GABA) and glutamate levels at baseline and week 12.


RESULTS
Seventy-one percent of evaluable subjects were considered responders to DVPX treatment by the OAS. There was a significant correlation between the Young Mania Rating Scale (YMRS) and OAS scores at week 0 (p = 0.036) and week 12 (p = 0.025). Serum DVPX level did not correlate with treatment response.


CONCLUSIONS
These youths who are at high risk for bipolar disorder experienced an overall decrease in aggressive behavior in response to DVPX. Age or gender did not predict a positive response to DVPX. This study is the first report of treatment efficacy of a mood stabilizer for aggression in youth at high risk for bipolar disorder.
Saxena
Kirti
K
Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Child Development, School of Medicine, Stanford University, 401 Quarry Road, Stanford, CA 94305, USA. ksaxena@stanford.edu
Howe
Meghan
M
Simeonova
Diana
D
Steiner
Hans
H
Chang
Kiki
K
D000293:Adolescent; D000339:Affect / Q000187:drug effects; D000374:Aggression / Q000187:drug effects*; D018692:Antimanic Agents / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000097:blood / Q000188:drug therapy; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000097:blood / Q000188:drug therapy; D001714:Bipolar Disorder; D002648:Child; D003527:Cyclothymic Disorder / Q000097:blood / Q000188:drug therapy; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy; D019263:Dysthymic Disorder / Q000097:blood / Q000188:drug therapy; D005260:Female; D018682:GABA Agents / Q000627:therapeutic use*; D018698:Glutamic Acid / Q000097:blood; D006801:Humans; D008297:Male; D012307:Risk Factors; D014635:Valproic Acid / Q000627:therapeutic use*; D005680:gamma-Aminobutyric Acid / Q000097:blood
D018692:Antimanic Agents; D018682:GABA Agents; D018698:Glutamic Acid; D005680:gamma-Aminobutyric Acid; D014635:Valproic Acid