Divalproex in posttraumatic stress disorder:
an open-label clinical
trial
by
Clark RD, Canive JM, Calais LA, Qualls CR, Tuason VB
Department of Pharmacy,
VA Medical Center,
Albuquerque, New Mexico 87108,
USA.
J Trauma Stress 1999 Apr; 12(2):395-401
ABSTRACT
Posttraumatic stress disorder (PTSD) is characterized by intrusive,
avoidance, and hyperarousal symptoms. This study was conducted to investigate
the effectiveness of divalproex in reducing PTSD symptoms, depression, and
anxiety in patients with PTSD. Sixteen patients with a DSM-IV diagnosis of PTSD
at the Albuquerque VAMC outpatient PTSD treatment program received an open-label
trial of divalproex. The patients were evaluated at baseline and at 8 weeks by a
trained rater using the Clinician Administered PTSD Scale (CAPS), the Hamilton
Rating Scale for Depression (HAM-D) and the Hamilton Rating Scale for Anxiety
(HAM-A). Plasma valproate levels were measured at the 8-week post-treatment
assessment. Three patients stopped the medications due to side effects.
Intrusion and hyperarousal symptoms decreased significantly, while no
significant change was seen in avoidance/numbing symptoms. Depressive symptoms,
as measured by the HAM-D, unexpectedly decreased at post-treatment assessment.
HAM-A scores also decreased significantly. Controlled trials are needed to
further study the efficacy of divalproex in the treatment of PTSD.
Options
Dysthymia
Anhedonia
Melancholy
Nefazodone
Anticonvulsants
Fluoxetine and PTSD
PTSD and bereavement
Future pharmacotherapies
PTSD: SSRIs versus Non-SSRIs