Psychiatric use and utility of divalproex sodium in Connecticut prisons.

Divalproex sodium (DVX) is used in correctional settings to treat impulsive aggression and mood lability in patients without comorbid bipolar disorder. This review of DVX use in the Connecticut Department of Correction examined the psychiatric diagnostic impression of patients prescribed DVX, the doses used, and the symptomatic and functional change over time. Clinical charts of 168 offenders treated with DVX for one or more months were randomly selected for clinical outcome review and were divided into subgroups based on clinical impression for DVX prescription. In participants without bipolar disorder (44.6%), DVX was used to target impulsivity (14.3%) and mood lability (17.3%). Clinical improvement was noted in bipolar and nonbipolar groups (p < .001). The impulsive/aggressive subgroup was the only nonbipolar subgroup in which DVX yielded clinical benefit. This symptom-driven use of DVX is associated with clinical improvement when impulsive aggression is the target symptom.