EFFECTIVENESS OF VALPROIC ACID ON DESTRUCTIVE AND AGGRESSIVE BEHAVIORS IN PATIENTS WITH ACQUIRED BRAIN INJURY

Valproic acid, a primary anticonvulsant drug, has recently been studie d for purported effectiveness in disparate disorders of mood and behav iour. The psychopharmacological treatment of patients with acquired br ain injury frequently includes numerous trials of psychotherapeutic dr ugs such as antipsychotics, benzodiazepines, antidepressants, and lith ium, in an effort towards affective and behavioural improvement. In th is report we describe and graphically depict the striking efficacy of valproic acid in reducing and improving destructive and aggressive beh aviours in five patients with acquired brain injury. In all cases valp roic acid was effective after other pharmacological interventions were not. Also, the addition of valproic acid was followed by neurobehavio ural improvement rather quickly, often within 1-2 weeks. Advantages of valproic acid, in addition to its possible unique efficacy, include a lower propensity towards sedation and cognitive impairment, and thus a more robust potential for rehabilitation participation. Behaviours a ssociated with affective disorders ranging along the affective spectru m from depression to dysphoric mania may be particularly amenable to v alproic acid. The drug may also be beneficial in some cases in which a nother psychotropic anticonvulsant, carbamazepine, was not.