Valproate is principally effective in manic aspects of bipolar disorder. Tolerability has been somewhat more favorable for valproate than comparators, with the frequent adverse effects being gastrointestinal disturbances and weight gain. Total cholesterol and low-density lipoproteins are reduced by valproate. Valproate is effective and well tolerated when combined with lithium or antipsychotic drugs. Valproate is efficacious in mixed and euphoric mania. In studies of maintenance versus placebo and active comparators, patients initially treated with divalproex for mania had more robust long-term benefits than in the full sample analyses. In maintenance treatment, patients whose valproate serum levels were between 75 and 99 microg/ml had longer time to discontinuation for any reason or a new mood episode than did patients receiving placebo. The profile of utility in bipolar disorders is principally for core features of manic symptomatology (e.g., impulsivity, hyperactivity and irritability), with little evidence of benefit for anxiety or psychosis. Valproate appears useful in other disorders that have behavioral dimensions inclusive of the domains that valproate benefits in bipolar disorders, such as schizophrenia.

译文

丙戊酸盐主要在躁郁症的躁狂方面有效。丙戊酸的耐受性比对照者更有利,常见的不利影响是胃肠道紊乱和体重增加。总胆固醇和低密度脂蛋白被丙戊酸盐降低。丙戊酸与锂或抗精神病药物合用有效且耐受性良好。丙戊酸盐在混合和喜快躁狂症中有效。在维持与安慰剂和活性比较者的研究中,与全样本分析相比,最初接受双丙戊酸钠治疗躁狂症的患者具有更强大的长期益处。在维持治疗中,丙戊酸盐血清水平在75至99 microg/ml之间的患者由于任何原因或新的情绪发作而停药的时间比接受安慰剂的患者更长。双相情感障碍的实用性主要是针对躁狂症状的核心特征 (例如,冲动,多动和易怒),几乎没有证据表明对焦虑或精神病有益。丙戊酸盐似乎在其他具有行为维度的疾病中有用,包括在双相情感障碍 (例如精神分裂症) 中丙戊酸盐有益的领域。

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