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Peanut WA
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(5/22/00 10:59 pm)
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Depakote and Bipolar Disorder
Here's the link: psychiatry.medscape.com/r...in017.html
For those of you who don't have an account with Medscape the article is as follows:
WESTPORT, May 15 (Reuters Health) - The results of the first placebo-controlled trial examining maintenance therapy for bipolar disorder I in 25 years indicate no clinically significant differences in patient outcome with divalproex, lithium or placebo, investigators report in the May issue of the Archives of General Psychiatry.
Dr. Charles L. Bowden of the University of Texas Health Science Center at San Antonio and colleagues randomized 369 patients from 37 participating centers to receive divalproex, lithium or placebo. The preliminary results showed no significant differences between the three treatment arms regarding the primary measure, which was the recurrence of any mood episode.
However, they did find that divalproex was significantly more effective than either placebo or lithium on several secondary outcome measures. Specifically, divalproex was more effective in reducing the "rates of recurrence of affective episodes severe enough to warrant patients' discontinuation from the study." Divalproex also showed a trend toward greater effectiveness in controlling subsyndromal depressive symptoms.
However, the divalproex group also had a significantly higher incidence of tremor, weight gain, sedation, infection, and tinnitus than the lithium group. Those treated with lithium exhibited a higher incidence of polyuria and thirst, and more patients dropped out due to intolerance to treatment or noncompliance.
Dr. Bowden's group points to some factors that could have contributed to the good outcomes in the placebo group, such as the exclusion of patients with more severe disease and the high level of support given the subjects. "The aggregate result... was a lower proportion of manic relapses in the placebo group than projected, yielding inadequate power to test the primary outcome variable," they write.
In an accompanying commentary, Dr. Ross J. Baldessarini of Harvard Medical School and associates discuss the difficulty and potential bias in subject recruitment for a placebo-controlled trial, sampling challenges, and the need to balance risks of dropouts against exposure times that match the natural course of untreated illness.
"The results of the divalproex study encourage renewed discussion of the scientific, clinical, ethical, and economic pros and cons of various options for future long-term trial designs," Dr. Baldessarini and colleagues conclude.
Arch Gen Psychiatry 2000;57:481-492..
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bkjj2
Global user
(5/28/00 7:58 am)
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Re: Depakote and Bipolar Disorder
Peanut Thanks for this info- I found it very interesting & I guess I am glad that the Depakote works for my Jared. Thanks again-Brenda
Brenda-30(Depression, OCD??)Prozac 40mg/day
Kelly-40(doesn't believe in mental illness, Very controlling jerk)
Jessica-10(my angel on most days)
Jared-9(the CHALLENGE of my life)Bipolar/ODD/ADHD Depakote 500mg/day
***Heal the past:Live the present:Dream the future.***
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