Efficacy, safety and practicability of valproate delayed release minitablets in bipolar affective disorders

Valproate has recently emerged as a drug of first choice in treating acute mania because of its efficacy and relative safety, It can be administered a s an intravenous, oral non-sustained release or oral sustained release load ing therapy. A new sustained release formulation of valproate consists of " mini-tablets" with the possible advantage of a less problematic and more re liable administration of the drug. We report on eleven patients with an acu te manic exacerbation who were investigated for sufficient control of manic symptoms and the duration of building up and maintaining sufficient blood levels of valproate in once/d versus twice/d administration of valproate de layed release mini-tablets (VPA mrt.). Acute and prophylactic effectiveness in mania were rated with the Young-Mania Rating Scale (YMRS), respectively the Global Clinical Impression Scale for Bipolar Disorder (CGI-BP). Result s: Within a short period of time sufficient blood levels in both groups (on ce/d Versus twice/d administration) were built up. Seven of eleven patients were responders according to a reduction of 50% of the YMRS. In respect of prophylactic treatment all of the ten patients showed satisfactory results and no re-exacerbation of manic symptoms or depression.