Document Detail


A comparison of divalproex and oxcarbazepine in aggressive youth with bipolar disorder.
MedLine Citation:
PMID:  16883146     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Divalproex (DVP) and oxcarbazepine (OXC) are used to treat pediatric bipolar disorder (PBPD) with severe aggression but these agents have not been compared in head to head trials.
METHODS: Electronic medical records were reviewed for those (age < 18) who received DVP (n = 20) or OXC (n = 11) for the treatment of PBPD with severe aggression. Change in prospectively rated Clinical Global Impressions-Severity (CGI-S) scores that measured global improvement of mental illness from baseline and rates of discontinuation due to adverse effects at approximately 4 months were the primary outcomes. CGI-S specific to aggression (CGI-Ag-S), which was rated retrospectively and blinded to treatment, was a secondary outcome.
RESULTS: Greater reduction in CGI-S scores occurred with DVP compared with OXC at 4 months (p = 0.007). Both CGI-S and CGI-Ag-S scores improved significantly from baseline to the 4-month timepoint with DVP but not OXC. There were no significant differences in weight changes between the groups. Rates of discontinuation due to adverse events were similar. However, more discontinuations due to worsening aggression occurred with OXC (DVP 0%, OXC 27.3%, p = 0.037). More patients receiving DVP had a decrease of 1 point or more on the CGI-S and had not discontinued due to adverse events as of the patient's last recorded visit on the index medication (DVP 13 (65%), OXC 2 (18%), p = 0.023).
CONCLUSIONS: OXC appeared less effective than DVP for PBPD with aggression in this study. Limitations included the small sample size and the open, nonrandomized, retrospective study design. Future prospective, double-blind studies are warranted to determine the place of OXC in the treatment of PBPD.
Authors:
Carlene M MacMillan; Sergio R Korndörfer; Sneha Rao; Carl A Fleisher; Enrico Mezzacappa; Joseph Gonzalez-Heydrich
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of psychiatric practice     Volume:  12     ISSN:  1527-4160     ISO Abbreviation:  J Psychiatr Pract     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-08-02     Completed Date:  2006-10-03     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  100901141     Medline TA:  J Psychiatr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  214-22     Citation Subset:  IM    
Affiliation:
Psychopharmacology Program, Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA. carlene_macmillan@hms.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aggression / psychology*
Antidepressive Agents / blood,  therapeutic use*
Bipolar Disorder / diagnosis,  drug therapy*
Carbamazepine / analogs & derivatives*,  blood,  therapeutic use
Child
Drug Administration Schedule
Female
Humans
Male
Prospective Studies
Retrospective Studies
Severity of Illness Index
Treatment Outcome
Valproic Acid / blood,  therapeutic use*
Chemical
Reg. No./Substance:
0/Antidepressive Agents; 298-46-4/Carbamazepine; 99-66-1/Valproic Acid; VZI5B1W380/oxcarbazepine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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