Divalproex sodium in sex offenders with bipolar disorders and comorbid paraphilias: an open retrospective study

Background: This study evaluated divalproex response in sex offenders with a bipolar disorder. Methods: We reviewed the records of all sex offenders w ho participated in a residential rehabilitative program who received divalp roex for treatment of a bipolar disorder. Patients' mood symptoms and, when present, comorbid paraphilic symptoms, were retrospectively assessed using the CGI severity scale. Results: Sex offenders displayed significant impro vement in manic symptoms with divalproex treatment. However, there was no s ignificant improvement in paraphilic symptoms in the subset of patients adm itting to these symptoms. Conclusion: Divalproex may be effective for manic symptoms in sex offenders with a bipolar disorder. However, for bipolar se x offenders with comorbid paraphilias, the drug may not be effective for pa raphilic symptoms. Limitations: This study was limited by its retrospective , open-label design, lack of systematic means of assessing manic and paraph ilic symptoms, and small sample size. Clinical relevance: Divalproex may be a helpful adjunct in the treatment of the subset of sex offenders who have a bipolar disorder. (C) 2001 Elsevier Science B.V. All rights reserved.