A preliminary controlled trial of divalproex in posttraumatic stress disorder.
BACKGROUND
Case reports and open trials have reported beneficial effects of divalproex in the treatment of posttraumatic stress disorder (PTSD). The objective of this study was to conduct a placebo-controlled study of the efficacy and tolerability of divalproex in chronic PTSD patients.


METHODS
Patients were randomized to receive placebo or divalproex. The primary outcome measure was the Clinician Administered PTSD Scale (CAPS).


RESULTS
Of 29 patients randomized, 16 received divalproex and 13 placebo. There were no significant differences between groups in mean change from baseline to end point (last observation carried forward) on the CAPS total score or subscales except for a significant decrease in avoidance/numbing scores with placebo. The only significant difference in secondary outcomes was a greater improvement in Clinical Global Impression Scale-Severity favoring placebo.


CONCLUSIONS
Divalproex was not superior to placebo in this study. This could be due to lack of efficacy of divalproex in this population, inadequate sample size to detect differences, or other factors. Further study of divalproex is needed to better clarify the role of this agent in PTSD.
Mental Health Service 116, Ralph H. Johnson VA Medical Center, 109 Bee Street Charleston, SC 29401, USA. hamnermb@musc.edu
Mark B
MB
Hamner
Richard A
RA
Faldowski
Sophie
S
Robert
Helen G
HG
Ulmer
Michael David
MD
Horner
Jeffrey P
JP
Lorberbaum
D000928:Antidepressive Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D011795:Surveys and Questionnaires; D014635:Valproic Acid / Q000627:therapeutic use*
D000928:Antidepressive Agents; D014635:Valproic Acid