title: Off-label use of sodium valproate for schizophrenia.
abstract: BACKGROUND
  Off-label use of a drug not according to its regulatory labeling has become common in medicine, especially in the field of psychiatry. Mood stabilizers are intended to be used to attenuate mood fluctuations in bipolar disorder, but their use has spread to patients with schizophrenia, as it provides greater control of impulsivity and aggressiveness. Sodium valproate is one of the most frequently used mood stabilizers in psychiatry. This study determined the prevalence of off-label use of sodium valproate for schizophrenia and schizoaffective disorder in Abarbanel Psychiatric Hospital and the demographic and clinical characteristics associated with its use.
  
  
  METHODS
  Retrospective study of patients hospitalized in 2011-2012 with a diagnosis of schizophrenia or schizoaffective disorder in one of three general psychiatric wards.
  
  
  RESULTS
  Valproate use was significantly lower in the geriatric group (11.6% vs. 20.1%, chi square  = 4.7, p = .03), in patients with schizophrenia (14.1% vs. schizoaffective disorder (35.2%), chi square  = 29, p<.001) and in patients receiving both atypical and typical antipsychotics (23.3% vs. 16.4%, p = .04). In multivariate logistic regression analysis, diagnosis and the combination of atypical and typical antipsychotics predicted the use of sodium valproate. The number of other medications prescribed did not predict sodium valproate use.
  
  
  CONCLUSIONS
  Off-label use of sodium valproate in psychiatric patients with schizophrenia or schizoaffective disorder is extensive, especially in younger patients and those with schizoaffective disorder. More research is needed to determine whether it is being prescribed appropriately.
authors.affiliation: Israeli Center for Technology Assessment in Health Care, Gertner Institute, Haim Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Einav
authors.initials: E
authors.lastname: Horowitz
authors.affiliation: Public Health and Health Systems Management Program, Bar Ilan University, Ramat Gan, Israel.
authors.forename: Lisa Carroll
authors.initials: LC
authors.lastname: Bergman
authors.affiliation: Yehuda Abarbanel Mental Health Center, Bat Yam, Israel.
authors.forename: Charna
authors.initials: C
authors.lastname: Ashkenazy
authors.affiliation: Teva Pharmaceutical Industries, Ltd., Petach Tikva, Israel.
authors.forename: Irit
authors.initials: I
authors.lastname: Moscona-Hurvitz
authors.affiliation: Public Health and Health Systems Management Program, Bar Ilan University, Ramat Gan, Israel.
authors.forename: Haya
authors.initials: H
authors.lastname: Grinvald-Fogel
authors.affiliation: Public Health and Health Systems Management Program, Bar Ilan University, Ramat Gan, Israel.
authors.forename: Racheli
authors.initials: R
authors.lastname: Magnezi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D056687:Off-Label Use / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D014635:Valproic Acid / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D014635:Valproic Acid