TREATMENT OF PSYCHIATRIC DISEASES WITH TH E ANTIEPILEPTIC DRUG VALPROATE

Besides the classical application in the treatment of different forms of epilepsies (generalized tonic-clonic seizures and absence seizures) valproate has also an efficacy in the treatment of psychic diseases. Open and controlled clinical studies have demonstrated positive effect s of the drug in the therapy of the acute manic syndrome and in the pr ophylaxis of bipolar affective and schizoaffective disorders. Moreover , some studies indicate an efficacy in panic disorders and the benzodi azepine withdrawal syndrome. In the present review the elementary mech anisms of action, the pharmacokinetic and pharmacodynamic effects, ind ications as well as side effects of valproate are described. The advan tage of valproate in comparison with lithium is that (i) lithium ions have strong side effect, (ii) a part of the patients are non-responder s to lithium and (iii) a possible non-response after a second therapy. The disadvantages of carbamazepine are especially the enzyme inductio n with the consequence of the failure of action of other drugs. In sum mary, the antiepileptic drug valproate is an important alternative in the therapy of affective disorders.