Divalproex Sodium for the Treatment of Conduct Disorder: A Randomized Controlled Clinical Trial
Abstract
BACKGROUND: New treatments for conduct disorder are sorely needed. We aimed to test the efficacy of divalproex sodium for the treatment of conduct disorder. METHOD: Seventy-one youths with conduct disorder according to DSM-IV criteria were enrolled in a randomized, controlled, 7-week clinical trial. Subjects were all adolescent males with at least 1 crime conviction. Subjects were randomized into high- and low-dose conditions and were openly managed by a clinical team. Subjects and independent outcome raters were blinded to condition. Clinical Global Impressions-Severity of Illness (CGI-S) and CGI-Improvement (CGI-I) ratings, Weinberger Adjustment Inventory ratings, and staff ratings of behavioral privilege were used to assess outcome. RESULTS: Intent-to-treat analyses showed significant associations between assignment to the high-dose condition and ratings on the CGI-S (p =.02) and CGI-I (p =.0008). Self-reported weekly impulse control was significantly better in the high-dose condition (p <.05), and association between improvement in self-restraint and treatment condition was of borderline statistical significance (p <.06). Parallel analyses comparing outcome by blood drug level achieved strengthened the results, as expected. CONCLUSION: This preliminary study in a most difficult population suggests a role for divalproex sodium in the treatment of conduct disorder. Divalproex sodium improved self-reported impulse control and self-restraint, variables shown to be predictive of criminal recidivism. Studies are needed of longer-term impact and side-effect profiles. This is one of few controlled psychopharmacologic studies of conduct disorder.
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Divalproex was found to be superior to placebo in treating explosive temper, mood lability, and CD in adolescents.
“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 [662]
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- Authors
- Steiner, H., Petersen, M. L., Saxena, K., Ford, S., & Matthews, Z.
- Affiliations
- Stanford Medicine (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2003-10-15
- Volume
- 64
- Issue
- 10
- Pages
- 1183-1191
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2068448083
- Cited by
- 110
- References
- 40
- Citations by year
- 2025: 3 · 2024: 7 · 2023: 1 · 2021: 3 · 2020: 1 · 2019: 6 · 2018: 2 · 2017: 5 · 2016: 7 · 2015: 4 · 2014: 2 · 2012: 6
- FWCI
- 10.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Keywords
- divalproex sodium, valproic acid, conduct disorder, adolescent boys, impulse control, self-restraint, psychopharmacologic treatment, recidivism, blood drug levels
- MeSH terms
- Adolescent, Aggression, Anger, Anticonvulsants, Arousal, Crime, Dose-Response Relationship, Drug, Double-Blind Method, Humans, Internal-External Control, Juvenile Delinquency, Male, Personality Assessment, Personality Inventory, Residential Treatment, Socialization, Valproic Acid, Treatment Outcome, Conduct Disorder
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