COMBINED TREATMENT OF SCHIZOPHRENIC PSYCHOSES WITH HALOPERIDOL AND VALPROATE

In accordance with a previous study of adjuvant effects of the anticon vulsant carbamazepine (CBZ) on the neuroleptic treatment of schizophre nic psychoses, the effects of valproate (VPA) were tested in a randoml y assigned double-blind, placebo-controlled study. Apart from a (stati stically nonsignificant) psychopathological deterioration following di scontinuation of VPA while on continuous neuroleptic mediation after f our weeks and a statistically significant effect on ''hostile belliger ence'', no overall therapeutic effects of the combination of haloperid ol (HPD) with VPA were observed under controlled conditions. Unlike th e results with CBZ, concomitant use of VPA led to an even higher consu mption of haloperidol and biperiden and to a higher rate of extrapyram idal symptoms compared with the corresponding placebo group, although these differences did not attain statistical significance. In regard t o use of the sedative neuroleptic chlorprothixene, there was a trend t oward lower doses in the VPA group than in the placebo group. From the se results, adjuvant effects like those of carbamazepine in the neurol eptic treatment of schizophrenic psychoses could not be confirmed for valproate in the present study. However, the trend toward lower doses of sedative medication and observed effects on ''hostile belligerence' ' may indicate sedative and/or antimanic properties of valproate which have recently been demonstrated in several controlled studies.