Low-dose divalproex in agitated patients with Alzheimer's disease

Journal of Psychiatric Practice
Christian Dolder, Jonathan McKinsey

Abstract

Adequate treatment of behavioral disturbances in Alzheimer's disease is both important and difficult. This report describes a case series that examined the effectiveness and safety of low-dose divalproex in the treatment of agitated patients with Alzheimer's disease who were admitted to an inpatient geriatric psychiatry unit over a 1-year period. All patients had agitation due to probable Alzheimer's disease or mixed dementia and were prescribed divalproex monotherapy at low and completely flexible doses. Patients and nursing staff were blind to study enrollment. Clinical global impression scale scores, divalproex serum levels, and a variety of medical chart data were collected. Twenty patients met selection criteria and were included in the study. Of those, 13 patients (65%) were considered responders, while 4 patients (20%) required augmentation with other psychotropic medications; divalproex was discontinued in 1 patient. Adverse events occurred in 25% of patients. This case series suggests that low-dose divalproex may offer behavioral improvement and a reduced risk of side effects for some patients with agitation in Alzheimer's disease.

References

Feb 7, 2001·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·A P PorsteinssonC Irvine
Jul 12, 2002·International Journal of Geriatric Psychiatry·Rob C SivalPiet Eikelenboom
Jul 3, 2003·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Anton P PorsteinssonChristopher Cox
Apr 6, 2004·International Journal of Geriatric Psychiatry·Rob C SivalPiet Eikelenboom
Nov 16, 2005·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Pierre N TariotUNKNOWN Valproate Nursing Home Study Group
Jul 4, 2006·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Constantine G LyketsosUNKNOWN Task Force of American Association for Geriatric Psychiatry
Dec 7, 2006·Dementia and Geriatric Cognitive Disorders·Nathan HerrmannGoran Eryavec
Sep 28, 2007·Therapeutic Drug Monitoring·Angela K BirnbaumIlo E Leppik

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Citations

Sep 13, 2011·Current Neurology and Neuroscience Reports·Howard S Kirshner
Jan 10, 2013·Pharmacological Reviews·Chi-Tso ChiuDe-Maw Chuang
Nov 19, 2011·Journal of Pharmacy Practice·Christian R DolderJonathan McKinsey

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