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Divalproex in the Management of Neuropsychiatric Complications of Remote Acquired Brain Injury

Received November 17, 2000; revised March 20, 2001; accepted March 26, 2001. From the Department of Psychiatry, University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, 671 Hoes Lane, Piscataway, NJ 08855-1392. Address correspondence to Dr. Kim. E-mail: kimed{at}cmhc.umdnj.edu

ABSTRACT

A retrospective chart review was conducted on 11 patients with a remote history of acquired brain injury (ABI) referred for psychiatric treatment who were treated with divalproex sodium alone or in combination with other psychotropic medications. The patients were highly heterogeneous. They had a variety of psychiatric symptoms and frequently received concomitant psychotropic medications. The mean daily dose of divalproex was 1,818±791 mg/day, serum valproic acid level 85.6±29.6 µg/ml. Mean Clinical Global Impression improvement score was 1.9±0.5. This is the largest postacute case series reported. It demonstrates that divalproex sodium is well tolerated and effective in reducing a broad range of neurobehavioral symptoms in psychiatric patients with a remote history of ABI.

Key Words: Brain Injury • Divalproex • Agitation

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