Valproate in the treatment of PTSD: systematic review and meta analysis.
OBJECTIVE
Anticonvulsants are used in clinical practice for the treatment of PTSD. However, a systematic investigation of their effects in the treatment of PTSD is currently lacking from the literature. Our aim is to review and appraise the evidence for the use of the anticonvulsant valproate for the treatment of PTSD.


METHODS
We performed a systematic review and meta-analysis of the literature where valproate was used for the treatment of PTSD. Studies of treatment of PTSD with valproate were located using a search protocol which was applied to the electronic databases CINAHL, EMBASE, MEDLINE and PSYCHINFO. A search of the National PTSD Centre Pilots Database and of the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR) were also conducted.


RESULTS
We only found one single-blinded study, four open-label studies and three case reports. These data do not allow for robust conclusions because of the design of the studies which are of limited patient number and open to bias. However, the studies reported that valproate was generally effective for the treatment of symptoms of PTSD by reducing hyperarousal, improving irritability and anger outbursts and improving mood.


CONCLUSIONS
The limited evidence base suggests that valproate can be effective as a monotherapy for the treatment of both PTSD and mood symptoms. A double blind controlled study should be the next step to robustly study the efficacy of valproate on the treatment of PTSD.
Adamou
Marios
M
R&D Centre, Kent Institute of Medicine and Health Sciences, University of Kent, Canterbury, Kent, UK. m.adamou@kent.ac.uk
Puchalska
Sylvia
S
Plummer
William
W
Hale
Anthony S
AS
D018692:Antimanic Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002986:Clinical Trials as Topic; D006801:Humans; D012107:Research Design; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy*; D014635:Valproic Acid / Q000627:therapeutic use*
D018692:Antimanic Agents; D014635:Valproic Acid