THE USE OF VALPROATE IN AN ELDERLY POPULATION WITH AFFECTIVE SYMPTOMS

Background: Little is known about the efficacy and tolerability of val proate in the elderly population with affective disorders, This pharma coepidemiologic study was undertaken to determine the side effect prof ile and efficacy of valproate in an elderly population with psychiatri c symptomatology. Method: This was a retrospective chart review of til l elderly inpatients at McLean Hospital who received valproate between May 8, 1989, and May 8, 1992. Chat-is were reviewed to determine gend er, discharge diagnosis, indication for the agent, and length of time on each medication, Charts were also reviewed for abnormalities in liv er function tests, blood cell dyscrasias, sedation, nausea and vomitin g, weight gain, impairment of cognition, tremor, and hair loss. The ef ficacy of the medication was also determined. Results: Thirty-five eld erly subjects who suffered from an affective disorder and who had rece ived valproate were identified. The mean age was 71.3 years. The mean length of the patient received valproate was 32.7 days. The mean dose was 743 mg/day, and the mean blood drug level was 52.9 mg/L. The valpr oate was rated as efficacious in Is (62%) of the 29 patients who had h ad an adequate drug trial at discharge. Overall, the medication was we ll tolerated. There were no reports of liver function test abnormaliti es. One patient experienced transient leukopenia. Other adverse events included two reports of nausea, two reports of sedation, and one comp laint of confusion. None of the variables examined were found to be st atistically significant in regard to efficacy. Conclusion; Valproate w as well tolerated and efficacious in this elderly population with affe ctive disorders. Further controlled studies are needed to confirm our results.