PMID- 19946935
OWN - NLM
STAT- MEDLINE
DCOM- 20100218
LR  - 20131121
IS  - 1099-1077 (Electronic)
IS  - 0885-6222 (Linking)
VI  - 24
IP  - 8
DP  - 2009 Dec
TI  - Augmentation of atypical antipsychotics with valproic acid. An open-label study 
      for most difficult patients with schizophrenia.
PG  - 628-38
LID - 10.1002/hup.1073 [doi]
AB  - OBJECTIVE: Most difficult inpatients with schizophrenia are in serious needs but 
      obviously underrepresented in clinical trials. METHODS: Very challenging patients 
      received open-label treatment with atypical antipsychotics concurrently augmented 
      with valproic acid. The primary outcome was the newly developed Functional 
      Assessment for Comprehensive Treatment of Schizophrenia (FACT-Sz). Patients 
      improving more than 20 points were classified as responders. RESULTS: Mean age 
      and illness duration of 28 participants (22 male) were 42 y.o. and 20 years, 
      respectively. They had spent a half of their life admitted after the onset. The 
      average Brief Psychiatric Rating Scale (BPRS) and Clinical Global 
      Impression-Severity (CGI-S) were very severe at 79 and 6.1, respectively, with 
      the baseline Global Assessment of Functioning (GAF) of as low as 21. As a result 
      of augmentation, there were nine responders, 12 partial responders, and seven 
      non-responders including only two patients who got worse. The main antipsychotics 
      were mostly either risperidone or olanzapine. Mean maximum oral dose and blood 
      level of valproic acid were 1907 mg and 91.7 microg/ml, respectively. Overall 
      significant improvements whilst to an inadequate degree were noted in clinical 
      parameters. Valproate augmentation was generally well tolerated but serious 
      adverse effects included thrombocytopenia, anaemia and sedation/falls. 
      CONCLUSIONS: While these preliminary results need to be tested against tenacious 
      monotherapy or polypharmacy involving clozapine, augmenting atypical 
      antipsychotics with valproic acid can be useful for very severe schizophrenia.
CI  - Copyright (c) 2009 John Wiley & Sons, Ltd.
FAU - Suzuki, Takefumi
AU  - Suzuki T
AD  - Department of Neuropsychiatry, Keio University School of Medicine, 35 
      Shinanomachi, Shinjuku-ku, Tokyo, Japan. takefumi@oak.dti.ne.jp
FAU - Uchida, Hiroyuki
AU  - Uchida H
FAU - Takeuchi, Hiroyoshi
AU  - Takeuchi H
FAU - Nakajima, Shinichiro
AU  - Nakajima S
FAU - Nomura, Kensuke
AU  - Nomura K
FAU - Tanabe, Akira
AU  - Tanabe A
FAU - Yagi, Gohei
AU  - Yagi G
FAU - Watanabe, Koichiro
AU  - Watanabe K
FAU - Kashima, Haruo
AU  - Kashima H
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - England
TA  - Hum Psychopharmacol
JT  - Human psychopharmacology
JID - 8702539
RN  - 0 (Antimanic Agents)
RN  - 0 (Antipsychotic Agents)
RN  - 614OI1Z5WI (Valproic Acid)
SB  - IM
MH  - Adult
MH  - Antimanic Agents/adverse effects/pharmacokinetics/*therapeutic use
MH  - Antipsychotic Agents/*therapeutic use
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Japan
MH  - Male
MH  - Middle Aged
MH  - Psychiatric Department, Hospital
MH  - Psychiatric Status Rating Scales
MH  - Schizophrenia/*drug therapy/physiopathology
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Valproic Acid/adverse effects/pharmacokinetics/*therapeutic use
EDAT- 2009/12/01 06:00
MHDA- 2010/02/19 06:00
CRDT- 2009/12/01 06:00
PHST- 2009/12/01 06:00 [entrez]
PHST- 2009/12/01 06:00 [pubmed]
PHST- 2010/02/19 06:00 [medline]
AID - 10.1002/hup.1073 [doi]
PST - ppublish
SO  - Hum Psychopharmacol. 2009 Dec;24(8):628-38. doi: 10.1002/hup.1073.