Comparing efficacy of ECT with and without concurrent sodium valproate therapy in
manic patients.
Author(s): Jahangard L, Haghighi M, Bigdelou G, Bajoghli H, Brand S.
Affiliation(s): Research Center for Behavioral Disorders and Substance Abuse, Hamadan University
of Medical Sciences, Hamadan, Iran.
Publication date & source: 2012, J ECT. , 28(2):118-23
OBJECTIVES: There is mixed evidence as to the merits of continuing versus
discontinuing medication with anticonvulsants before starting electroconvulsive
therapy (ECT) in patients with manic episodes. The aim of the present study was
therefore to compare, in a controlled double-blind randomized clinical trial,
treatment improvements and treatment outcome in patients with current manic
episodes while treated with ECT with and without concurrent sodium valproate
therapy.
METHODS: A total of 42 inpatients (mean [SD] age, 32.1 [9.6]; 88% men) with
bipolar disorders and currently during a manic state took part in the study. They
were randomly assigned either to the target group (continuation of sodium
valproate administration; minimum, 750 mg/d) or to the control group
(discontinuation of sodium valproate administration). All patients underwent
bifrontal ECT for at least 6 sessions. Improvements were rated with the Young
Mania Rating Scale and the Clinical Global Impression (CGI; CGI-Severity of
Illness, and CGI-Improvement).
RESULTS: Manic episodes as assessed by the Young Mania Rating Scale and CGI
improved significantly over time and irrespective of group (target vs control
group).
CONCLUSIONS: The pattern of results from this double-blind randomized clinical
trial suggests that continuing administration of the anticonvulsant sodium
valproate does neither adversely affect nor enhance the efficacy of ECT
inpatients with manic episodes.
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