VALPROIC ACID TREATMENT OF AGITATION IN DEMENTIA

Objective: Valproic acid, an anticonvulsant medication that enhances G ABAergic neurotransmission, has been shown to be helpful in treating b ehavioural disturbances associated with dementia in several small case series. In an attempt to further document its effectiveness and safet y, valproic acid was used to treat a group of elderly patients with de mentia and severe agitation. Method: Sixteen patients, aged 68 to 95 y ears, who were previously unresponsive to other pharmacotherapeutic in terventions, were treated prospectively with open-label divalproex sod ium. Effectiveness was measured with the Behave AD (B-AD), the Cohen-M ansfield Agitation Inventory, (CMAI), and the Clinical Global Impressi on Scale (CGIS). Doses ranged from 750 to 2500 mg, divided, per day, w ith levels of 184 to 742 mu mol/L. Results: Scores on the CMAI decline d from 68.8 to 61.0 (P < 0.005), and scores on the B-AD declined from om 15.8 to 12.3 (P < 0.004). On the CGIS, 1 patient was rated as very; much improved, 3 patients were much improved, 4 patients were minimal ly improved, and 8 patients were unchanged. The drug was prematurely d iscontinued in only 1 patient because of side effects. Conclusion: Val proic acid was shown to be well tolerated with modest effectiveness.