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Divalproex Treatment for Youth With Explosive Temper and Mood Lability: A Double-Blind, Placebo-Controlled Crossover Design
Abstract
OBJECTIVE: The authors sought to replicate open-label findings showing that specific criteria for explosive temper and mood lability identify disruptive youth who improve while receiving the anticonvulsant divalproex sodium. METHOD: Twenty outpatient children and adolescents (ages 10-18) with a disruptive behavior disorder (oppositional defiant disorder or conduct disorder) met the specific criteria for explosive temper and mood lability. They received 6 weeks of divalproex treatment and 6 weeks of placebo by random assignment. Independent evaluators blind to group assignment assessed response at the end of each phase. RESULTS: At the end of phase 1, eight of 10 subjects had responded to divalproex; zero of 10 had responded to placebo. Of the 15 subjects who completed both phases, 12 has superior response taking divalproex. CONCLUSIONS: This preliminary study replicates open-label findings showing that divalproex is an efficacious treatment for explosive temper and mood lability in disruptive children and adolescents.
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“However, a comparison of behavior therapy combined with either divalproex or stimulants found that the use of divalproex was more efficacious in children with severe aggressive behavior, most of whom also had ADHD (118).”
From Emotion Dysregulation in Attention Deficit Hyperactivity Disorder (2014) · cites this paper as [118]
In the citing paper
“Divalproex was found it to be superior to placebo in treating explosive temper, mood lability [661], and CD [662] in adolescents.”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [661]
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Self-citationDivalproex Sodium for Impulsive Aggressive Behavior in Patients With Personality Disorder
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“80% of divalproex subjects responded well, but no one in the placebo group responded [21].”
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“Improved behavioral dyscontrol and aggression with valproate treatment has also been noted in patients with PTSD (120–122), temper outbursts (118,119,123), TBI (124,125), dementia (116,126–129), and autism (130).”
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“Divalproex was superior to placebo, with no reported adverse effects.(53) A fifth trial added divalproex to open stimulant treatment in youth with ADHD and ODD or CD for the treatment of aggression.”
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“Similar effects have been obtained by giving adolescents with explosive temperament divalproex, a drug normally used to combat epilepsy or bipolar disorder [124, 125].”
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Chapter 15. Psychopharmacology and Electroconvulsive Therapy
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Psicofarmacologia e terapia elettroconvulsivante
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Metadata
- Authors
- Donovan, S. J., Stewart, J. W., Nunes, E. V., Quitkin, F. M., Parides, M., Daniel, W., Susser, E., & Klein, D. F.
- Affiliations
- New York State Psychiatric Institute (US)
- Venue
- American Journal of Psychiatry
- Published
- 2000-05-01
- Volume
- 157
- Issue
- 5
- Pages
- 818-820
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2154371517
- Cited by
- 273
- References
- 6
- Citations by year
- 2025: 7 · 2024: 4 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 2 · 2019: 2 · 2018: 5 · 2017: 12 · 2016: 18 · 2015: 7 · 2014: 10 · 2013: 2 · 2012: 9
- FWCI
- 20.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Drug Abuse (DA00246)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- divalproex sodium, valproic acid, emotional lability, disruptive behavior disorders, oppositional defiant disorder, conduct disorder, children and adolescents, anticonvulsant therapy, placebo response, replication
- MeSH terms
- Adolescent, Ambulatory Care, Anticonvulsants, Child, Double-Blind Method, Drug Administration Schedule, Female, Humans, Disruptive, Impulse Control, and Conduct Disorders, Male, Placebos, Psychiatric Status Rating Scales, Valproic Acid, Comorbidity, Treatment Outcome, Cross-Over Studies, Attention Deficit and Disruptive Behavior Disorders, Mood Disorders
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