Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-22T19:11:42.291Z Has data issue: false hasContentIssue false
  • English
  • Français

Valproate (depakine-chrono) in the acute treatment of outpatients with generalized anxiety disorder without psychiatric comorbidity: Randomized, double-blind placebo-controlled study

Published online by Cambridge University Press:  16 April 2020

Nadir A. Aliyev  and
Zafar N. Aliyev
Nadir A. Aliyev*
Affiliation:
Mental Clinic for Outpatients of Baku City, U.Chagibekov Street, 46/50, F.1, Baku P.O. AZ0010, Azerbaijan Republic
Zafar N. Aliyev
Affiliation:
Mental Clinic for Outpatients of Baku City, U.Chagibekov Street, 46/50, F.1, Baku P.O. AZ0010, Azerbaijan Republic
*
*Corresponding author. E-mail address: [email protected] (N.A. Aliyev).
Get access

Abstract

Objective

Anxiety disorders are highly prevalent in population of European countries. However, the effect of Valproate (depakine-chrono) on generalized anxiety disorder (GAD) has not been studied in a double-blind placebo-controlled design.

Method

Eighty patients (all men) were washout from the all medications. Each patient was randomized to receive either depakine-chrono (40 patients) for 6 weeks or matched placebo (40 patients) in a double-blind manner. Eligible participants, in addition to meeting the DSM-IV criteria for GAD and having a minimum score of 25 and more on the Hamilton Anxiety Scale, were required to be between 18 and 65 years. Response was defined as a 50% reduction in the Hamilton anxiety scale score. Response and side effects with depakine-chrono and placebo were compared by using analysis of variance (ANOVA) and chi-square tests. Six patients did not return for at least one subsequent assessment, leaving 74 patients (36 taking depakine-chrono and 38 taking placebo) in the valuables study group.

Results

Twenty six of the 36 depakine-chrono-treated participants responded by 6 weeks, versus six of the 38 placebo-treated participants (p < 0.001). The most common and problematic side effect in the depakine-chrono group was dizziness and nausea.

Conclusions

The authors believe this to be the first double-blind placebo-controlled randomization study to test the efficacy of a depakine-chrono in the management of anxiety disorders. They need to be replicated in a larger study group.

Keywords

Depakine-chronoGeneralized anxiety disorderTreatment
Type
Original articles
Information
European Psychiatry , Volume 23 , Issue 2 , March 2008 , pp. 109 - 114
Copyright
Copyright © Elsevier Masson SAS 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baetz, M., Browen, R.C.Efficacy of divalproex sodium in patients with panic disorder and mood instability who have not responded to conventional therapy. Can J Psychiatry 1998 Feb;43(1):73–77.CrossRefGoogle Scholar
Baldwin, D.S., Anderson, I.M., Nutt, D.J., Bandelow, B., Bond, A., Davidson, J.R.T.et al.Evidence-based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British Association for Psychopharmacology. J Psychopharmacol 2005;19(6):567–596.CrossRefGoogle ScholarPubMed
Balfour, J.A., Bryson, H.M.Valproic Acid. A review of its pharmacology and therapeutic potential in indication other than epilepsy. CNS Drug 1994;2:144–173.CrossRefGoogle Scholar
Bandelow, B., Wedekind, D., Leon, T.Pregabalin for the treatment of generalized anxiety disorder: a novel pharmacologic intervention. Expert Rev Neurother 2007 Jul;7(7):769–781.CrossRefGoogle ScholarPubMed
Barre, J., Berger, Y., Pharmacokinetics of a newly developed sustained release from of sodium valproate. In: Chadwick, D., editor. Proceedings of the Four International Symposium on Sodium Vaproate and Epilepsy, International Congress and Symposium Series No 152. Royal Society of Medicine Services, London, 1989.Google Scholar
Barros, H.M., Tannhauser, M.A., Tannhauser, M.Effect of sodium valporate on the open-field behavior of rats. Braz J Med Biol Res 1992;25(3):281–287.Google Scholar
Becker, H.C., Anton, R.F.Valproate potentiates and picrotoxin antagonizes the anxiolytic action of ethanol in a nonshock conflict task. Neuropharmacology 1990 Sep;29(9):837–843.CrossRefGoogle Scholar
Boulenger, J.P., Capdevielle, D.Pharmacological treatment of generalized anxiety disorders: rationale and limitations. Encephale 2007 Jan–Feb;33(1):84–94.CrossRefGoogle ScholarPubMed
Clark, R.D., Caive, J.M., Calais, L.A., Qualls, C.R., Tuason, V.B.Divalproex in posttraumatic stress disorder: an open-label clinical trial. J Trauma Stress 1999 Apr;12(2):395–401.CrossRefGoogle ScholarPubMed
Corbett, R., Fielding, S., Cornfeldt, M., Dunn, R.W.GABAmimetic agents display anxiolitic-like effects in the social interaction and elevated plus maze procedures. Psychopharmocology (Berl) 1991;104(3):312–316.CrossRefGoogle Scholar
Coryell, W.Panic disorder and mortality. Psychiatr Clin North Am 1988;11:433–440.CrossRefGoogle ScholarPubMed
Dalvi, A., Rodgers, R.J.Anxiolytic effects of valproate and diazepam in mice are differentially sensitive to picrotoxin antagonism. Pharmacol Biochem B 2001 Jan;68(1):23–32.CrossRefGoogle ScholarPubMed
Davis, R., Peters, D.H., McTavish, D.Valproic acid. A reappraisal of its pharmacological properties and clinical efficacy in epilepsy. Drugs 1994;47(2):332–372.CrossRefGoogle ScholarPubMed
Davis, L.L., Ryan, W., Adinoff, B., Petty, F.Comprehensive review of the psychiatric uses of valproate. J Clin Psychopharmacol 2000 Feb;20(1 Suppl. 1):1S–17S.CrossRefGoogle ScholarPubMed
De Angelis, L.Effects of valproate and lorazepam on experimental anxiety: tolerance, withdrawal, and role of clonidine. Pharmacol Biochem Behav 1995 Oct;52(2):329–333.CrossRefGoogle ScholarPubMed
First, M.B., Spitze, R.L., Gibbon, M., Williams, J.B.W.Structured clinical interview for DSM-IV Avis I disorders, patient edition (SCID-P), and version 2. New York: New York State Psychiatric Institute, Biometrics Research; 1995.Google Scholar
Glantz, A.S.Primer of biostatisties. (Russian translation from English by I.A. Danilov) Moscow, Russia; 1999.Google Scholar
Hamilton, M.The assessment of anxiety states by rating. Br J Med Psychol 1959;32:50–55 [Medline].CrossRefGoogle ScholarPubMed
Katon, W.Panic disorder: relationship to high medical utilization, unexplained physical symptoms, and medical costs. J Clin Psychiatry 1996;57(Suppl 10):11–18.Google ScholarPubMed
Keck, P.E. Jr., McElroy, S.L., Friedman, L.M.Valproate and carbamazepine in the treatment of panic and posttraumatic stress disorders, withdrawal states, and behavioral dyscontrol syndromes. J Clin Psychopharmacol 1992 Feb;12(1 Suppl):36S–41S.CrossRefGoogle ScholarPubMed
Keck, P.E. Jr., Mc Elroy, S.L., Tugrul, K.C., Bennet, J.A., Smith, J.M.Antiepileptic drugs for treatment of panic disorder. Neuropsychobiology 1993;27(3):150–153.CrossRefGoogle ScholarPubMed
Keck, P.E. Jr., Taylor, V.E., Tugrul, K.C., McElroy, S.L., Bennett, J.A.Valproate treatment of panic disorder and lactate-induced panic attacks. Biol Psychiatry 1993;33:542–546.CrossRefGoogle ScholarPubMed
Kinrys, G., Pollack, M.H., Simon, N.M., Worthington, J.J., Nardi, A.E., Versiani, M.Valproic acid for the treatment of social anxiety disorder. Int Clin Psychopharmacol 2003 May;18(3):169–172.Google ScholarPubMed
Lang, A.P., de Angelis, L.Experimental anxiety and antiepileptics: the effects of valproate and vigabatrin in the mirrored chamber test. Methods Find Exp Clin Pharmacol 2003 May;25(4):265–271.CrossRefGoogle ScholarPubMed
Longo, L.P., Campbell, T., Hubatch, S.Divalproex sodium (Depakote) for alcohol withdrawal and relapse prevention. J Addict Dis 2002;21(2):55–64.CrossRefGoogle ScholarPubMed
Lum, M., Fontaine, R., Elie, R., Ontiveros, A.Divalproex sodium's antipanic effect in panic disorder. A placebo-controlled study. Biol Psychiatry 1990;27:164A–165A.Google Scholar
Nemeroff, C.B.The role of GABA in the pathophysiology and treatment of anxiety disorders. Psychopharmacology Bull 2003;37(4):133–146.Google ScholarPubMed
Ontiveros, A., Fontain, R.Sodium valproate and clonazepam for treatment-resistant panic disorder. J Psychiatry Neurosci 1992 June;17(2):78–80.Google ScholarPubMed
Pande, A.C., Feltner, D.E., Jefferson, J.W., Davidson, J.R., Pollaack, M., Stein, M.B.Efficacy of the novel anxiolytic pregabalin in social anxiety disorder: a placebo-controlled, multicenter study. J Clin Psychopharmacol 2004;24(2):141–149.CrossRefGoogle ScholarPubMed
Primeau, F., Fontaine, R., Beauclair, L.Valporic acid and panic disorder. Can J Psychiatry 1990;35:248–250.CrossRefGoogle Scholar
Raevskii, K.S., Aleksandrovekii, IuA, Poiurovslii, M.V., Kharlamov, A.N., Neznamov, G.G.[Anxiolytic action of sodium valproate (possible for role of gamma-aminobutric acid in affective disorders)-Article in Russian]. Zh Nevropatol Psikiatr Im S S Korsakova 1985;85(4):574–579.Google Scholar
Reed, R.C., Dutta, S.What is best strategy for converting from twice-daily divalproex to a once-daily divalproex ER regimen? Clin Drug Invest 2004;24(9):509–521.CrossRefGoogle ScholarPubMed
Reoux, J.P., Saxon, A.J., Malte, C.A., Baers, J.S., Sloan, K.L.Divalproex sodium in alcohol withdrawal: a randomized double-blind placebo-controlled clinical trial. Alcohol Clin Exp Res 2001 Sep;25(9):1324–1329.CrossRefGoogle ScholarPubMed
Rodina, V.I., Krupina, N.A., Kryzhanovslii, G.N.A new natural model of elevated anxiety in rats (article in Russian). Biull Eksp Biol Med 1993 Aug;116(8):127–130.Google Scholar
Roy-Byrne, P.P., Ward, N.G., Donnely, P.J.Valproate in anxiety and withdrawal syndromes. J Clin Psychiatry 1989 Mar;50(Suppl):44–48.Google ScholarPubMed
Shepard, R.A.Behavioral effects of GABA agonists in relation to anxiety and bendiazepline action. Life Sci 1987 June 22;40(25):2429–2436.CrossRefGoogle Scholar
Simiand, J., Keane, P.E., Morre, M.The staircase test in mice: a simple and efficient procedure for primary screening agents. Psychopharmacology (Berl) 1984;84(1):48–53.CrossRefGoogle Scholar
Spila, B., Szumillo, A.Gabapentin (GBP) in panic disorders—case report. Psychiatr Pol 2006 Nov–Dec;40(6):1061–1068.Google ScholarPubMed
Stein, D.J., Simeon, D., Frenkel, M., Islam, M.N., Hollander, E.An open trial of valproate in borderline personality disorder. J Clin Psychiatry 1995 Nov;56(11):506–510.Google ScholarPubMed
Van Ameringen, M., Mancini, C., Pipe, B., Bennet, M.antiepileptic drugs in the treatment of anxiety disorders: role in therapy. Drugs 2004;64(19):2199–2220.CrossRefGoogle ScholarPubMed
Weissman, M.M., Bland, R.C., Canino, G.J., Faravelli, C., Greenwald, S., Hwu, H.-G.et al.The cross-national epidemiology of panic disorder. Arch Gen Psychiatry 1997;54:305–309.CrossRefGoogle ScholarPubMed
Wittchen, H., Jacobi, F.Size and burden of mental disorders in Europe-a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol 2005;15(4):357–376.CrossRefGoogle ScholarPubMed
Woodman, C.L., Noyes, R. Jr.Panic disorder: treatment with valproate. J Clin Psychiatry 1994 Apr;55(4):134–136.Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.