Background
The aim of this study was to evaluate the efficacy of divalproex (VLP) to prevent
episode recurrence in postpartum women with bipolar disorder.
Methods
The design was a single-blind, nonrandomized clinical trial. Subjects were enrolled
during pregnancy and chose either VLP plus symptom monitoring or monitoring without
medication for immediate postpartum management. Mania and depression symptoms were
assessed weekly for 20 weeks by an independent evaluator.
Results
Data were available for 26 women. There were no significant differences between groups
in the proportions of women who developed postpartum hypomania/mania, depression,
or mixed states. The time to development of episodes also did not vary between groups.
Women who were treated with VLP tended to have lower levels of hypomanic/manic symptoms.
Conclusions
Divalproex was not significantly more effective than monitoring without drug for the
prevention of postpartum episodes of bipolar disorder. The most prudent pharmacologic
plan is to use the drug(s) to which the individual woman has responded and prepare
a plan for rapid augmentation if a breakthrough episode occurs.
Key words
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Article info
Publication history
Accepted:
July 30,
2004
Received in revised form:
July 22,
2004
Received:
May 14,
2004
Identification
Copyright
© 2004 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.