Brown R
Department of Psychiatry, Columbia University, New York, NY.
J Clin Psychiatry. 1989 Mar;50 Suppl:13-6.
Valproic acid and its enteric-coated derivative, divalproex sodium, have been used extensively in a wide variety of seizure disorders. Recent preliminary research demonstrates the effectiveness of valproate in the treatment of manic-depressive illness, including acute mania, prevention of bipolar episodes, and schizoaffective disorder. In uncontrolled and controlled studies, treatment-resistant patients with these disorders have responded well to valproate. Preliminary results of an ongoing community-based open trial of valproate treatment of those affective illnesses reveal that valproate is frequently effective and has a favorable side effect profile. Overall, approximately two out of three patients with refractory bipolar disorder respond to acute therapy with valproate. Response in schizoaffective patients has been moderate, and valproate seems to be less effective in the treatment of depression. Experience suggests the importance of monitoring plasma drug levels to maximize efficacy and minimize potential toxicity.
丙戊酸及其肠溶包衣衍生物丙戊酸钠已广泛用于多种癫痫发作疾病。最近的初步研究表明丙戊酸盐在治疗躁狂抑郁症方面有效，包括急性躁狂、预防双相情感障碍发作以及分裂情感性障碍。在非对照和对照研究中，患有这些疾病的难治性患者对丙戊酸盐反应良好。一项正在进行的基于社区的丙戊酸盐治疗这些情感疾病的开放试验的初步结果显示，丙戊酸盐通常有效且副作用较小。总体而言，约三分之二的难治性双相情感障碍患者对丙戊酸盐的急性治疗有反应。分裂情感性障碍患者的反应中等，丙戊酸盐在治疗抑郁症方面似乎效果较差。经验表明监测血浆药物水平对于最大化疗效和最小化潜在毒性很重要。
