ผู้วิจัย/Authors: Thawatchai Leelahanaj.

ชื่อเรื่อง/Title: Valproate in the Treatment of Bipolar Disorders.

แหล่งที่มา/Source: Journal of the Psychiatric Association of Thailand. Vol.51, No.3, July-September 2006, Page 86.

รายละเอียด / Details:

Objective: To review the literatures on the use of valproate in the treatment of bipolar disorder and highlight the evidence base supporting its efficacy and tolerability. Method: The literatures were reviewed and subdivided into the following sections: mechanism of action, efficacy, drug administration and adverse reaction. Results: Several mechanisms of action of valproate on central nervous system neuron that may be relevant to its actions in bipolar disorder have been recently reported. These include inhibition of glycogen syntheses kinase and histone deacetylase. Valproate is effective in treatment of mania, and somewhat more effective in certain patient subgroups than the other treatments e.g. mixed episode, and mania with rapid cycling course. Valproate is comparable with lithium and olanzapine in maintenance treatment, and somewhat better tolerated. Several studies indicate that valproate can be beneficially combined with antipsychotic drugs and other treatments for bipolar disorder. Accelerated oral loading with valproate is a feasible and safe method to bring serum valproate concentrations to effective levels rapidly. Higher serum levels, particular above 110 g/ml are associated with more reports of weight gain, sedation, and reduction of platelet count. Valproate reduces total cholesterol levels and low density lipoprotein. Valproate contributes significantly to the development of menstrual abnormalities. The risk of developing polycystic ovarian syndrome with valproate use requires further study. Conclusion: Valproate treatment continues to be studied for further clarification of its mechanisms, efficacy, risks, and spectrum of benefits in bipolar disorder. In the meantime, it is a major treatment of bipolar disorder, both in monotherapy and combination therapy regimens.

Keywords: valproate treatment, bipolar disorder, mania, efficacy, adverse reaction, review literature, drug administration, serum valproate, psychiatry

ปีที่เผยแพร่/Year: 2006

Address: Department of Psychiatry and Neurology, Phramongkutklao Hospital.

Code: 200700015

ISSN/ISBN: 0125-6985

Country of publication: Thailand.

Language: English

Category: Abstract Journal.

Download: