Effect of divalproex sodium on aggression and self-injurious behaviour in adults with intellectual disability: a retrospective review

The aim of the present study was to evaluate the efficacy of divalproex sod ium treatment in adults with intellectual disability, and aggressive or sel f-injurious behaviour. Twenty-eight adults aged between 20 and 63 years of age with severe, long-lasting behavioural problems were treated with divalp roex sodium (dosage 500-4000 mg day(-1)). Clinical changes were assessed at 2-73 months into the pharmacological treatment utilizing the Clinical Glob al Impression Severity (CGI-S) scale, and monthly behavioural counts of agg ressive and self-injurious acts. Seventy-one percent of subjects demonstrat ed a moderate or marked improvement on the CGI-S; another 21% demonstrated mild benefits. Among the patients for whom objective prospective behavioura l counts were available, 88% showed a significant reduction in aggression a nd self-injurious behaviour, 46% had other psychotropic medications discont inued, and another 39% had psychotropic medications decreased. One patient had serious thrombocytopenia which required the discontinuation of divalpro ex sodium, and one other had vomiting and worsened aggression. The present preliminary, uncontrolled study suggests that adults with intellectual disa bility, and aggressive or; self-injurious behaviour may respond to divalpro ex sodium, and that this drug is well-tolerated in the majority of subjects .