PMID- 25083273
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140801
LR  - 20211021
IS  - 2045-1253 (Print)
IS  - 2045-1261 (Electronic)
IS  - 2045-1253 (Linking)
VI  - 4
IP  - 4
DP  - 2014 Aug
TI  - Adjuvant valproate therapy for patients with suspected mixed-depressive features.
PG  - 143-8
LID - 10.1177/2045125314532868 [doi]
AB  - OBJECTIVE: Mixed-depressive features imply an occult bipolarity and might be 
      linked to resistance to antidepressant therapy and a higher risk of suicide. 
      Currently, there is no consensus about or any clinical guidelines available for 
      this ill-defined clinical entity. The aim of this study was to assess the 
      effectiveness, safety, and tolerability of mood stabilizers, such as valproate, 
      for adjuvant therapy in patients suspected of having mixed-depressive features. 
      METHODS: This retrospective observational study reviewed medical records of 
      psychiatric outpatients attended by the author from 2008 to 2013. Patients who 
      presented with inadequately treated, long-lasting atypical depressive- and/or 
      anxiety-spectrum symptoms, and who started adjuvant valproate therapy for the 
      first time in their course of treatment, were identified. Patient demographics, 
      clinical profiles, treatment responses, and treatment-emergent adverse events 
      (AEs) were examined in detail. RESULTS: A total of 22 patients (7 men and 15 
      women) ranging in age between 25 and 78 years were treated with valproate 
      100-1250 mg/day and observed for 3-60 months. The majority exhibited much or 
      moderate improvement, and only four showed a limited response. During follow up, 
      12 continued adjuvant valproate, 3 were intermittent users, and 3 quit after no 
      apparent response; 4 experienced an aggravation of symptoms after discontinuation 
      but were stabilized soon after reinstitution. AEs were reported by 12 patients 
      and 4 stopped valproate for intolerability despite improvement. CONCLUSION: 
      Adjuvant valproate therapy seems to be a promising approach to treating patients 
      who manifest atypical neurotic or mood disorders with subthreshold bipolarity at 
      a dosage around the lower end of that used to treat full-syndromal bipolar 
      disorders.
FAU - Liu, Chen-Chung
AU  - Liu CC
AD  - Department of Psychiatry, National Taiwan University Hospital, No. 7 Chung-Shan 
      South Road, Taipei, 10002, Taiwan.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Ther Adv Psychopharmacol
JT  - Therapeutic advances in psychopharmacology
JID - 101555693
PMC - PMC4104709
OTO - NOTNLM
OT  - adjuvant therapy
OT  - bipolarity
OT  - depressive-mixed states
OT  - mixed-depressive features
OT  - valproate
COIS- Conflict of interest statement: The author has served as a speaker and received 
      honoraria from Astra-Zeneca, Eli Lilly, Janssen-Cilag, Otsuka, Pfizer, and 
      Sanofi.
EDAT- 2014/08/02 06:00
MHDA- 2014/08/02 06:01
PMCR- 2014/08/01
CRDT- 2014/08/02 06:00
PHST- 2014/08/02 06:00 [entrez]
PHST- 2014/08/02 06:00 [pubmed]
PHST- 2014/08/02 06:01 [medline]
PHST- 2014/08/01 00:00 [pmc-release]
AID - 10.1177_2045125314532868 [pii]
AID - 10.1177/2045125314532868 [doi]
PST - ppublish
SO  - Ther Adv Psychopharmacol. 2014 Aug;4(4):143-8. doi: 10.1177/2045125314532868.