Divalproex sodium treatment in late adolescent and young adult acute mania.

This is a preliminary report on 6 subjects in an ongoing open trial of divalproex sodium in the treatment of adolescents with bipolar affective disorder who are experiencing an acute manic episode. The 7-week study was designed to determine the relative potential efficacy and safety of divalproex sodium in this condition before further assessment of the medication with a comparative lithium condition. Patients were assessed weekly with the Modified Mania Rating Scale (MMRS), the Brief Psychiatric Rating Scale (BPRS), and the Global Assessment Scale (GAS). The primary outcome measure was the MMRS. Of the 6 patients, 5 showed marked improvement (pre-post decrease > 60%), 1 showed some improvement (pre-post decrease of 20-60%), and none failed to improve (pre-post decrease of < 20%). The mean MMRS score was significantly reduced by 7 weeks of treatment (pre to post mean score: 77 +/- 25.79 to 29 +/- 24.97, t = 9.45, p < .0002), as were the BPRS (40.67 +/- 14.91 to 18.67 +/- 11.83, t = 5.98, p < .0019) and the GAS (28.5 +/- 12.78 to 48 +/- 15.03, t = 6.71, p < .0011). All patients were on ancillary psychotropic medications during this study.