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Valproate for acutre mood episodes in bipolar disorder

Macritchie K, Geddes J, Scott J, Haslam DR, Silva de Lima M, Goodwin G
Published Online: 
21 January 2009

This systematic review investigated the efficacy and acceptability of valproate compared to that of placebo, lithium, carbamazepine, olanzapine and haloperidol in the treatment of acute episodes of bipolar disorder. Ten randomised studies were included in the review: all examined patients with mania. Valproate was more effective than placebo in the treatment of mania. There was no significant difference between efficacy in valproate and lithium or between valproate and carbamazepine, but there were fewer data on these comparisons and so these questions remain unanswered. The evidence suggests that valproate may be less effective in reducing manic symptoms than olanzapine but may cause less sedation and weight gain. There remains a need for more trials comparing medicines in treating all affective episodes.