[Use of valpromide in psychiatric therapeutics]

Abstract

Valpromide is obtained from amidification of valproic acid. Bio-pharmacological data show several possible mechanisms of action involving an increase in GABA levels in brain as well as changes in membrane conductance on neurons. Valpromide has been shown to decrease aggressivity in stress-induced animals, to regulate anxious induced behaviours, as well as to potentiate central sedative compounds. Valpromide had no sedative effect on man when used in monotherapy. It produces a significant increase of cognitive functions. Psychopathological experiments have shown: a wakening of personality, euphoric effects, an improvement of social behaviour, a stabilization of mood in affective disorders. A potentiation of other CNS drugs (mainly sedative compounds) has been observed. Dosage should be reduced when valpromide is used in combination with these drugs. In manic depression, valpromide has shown a preventive action. Current studies showed that the number of repeated hospitalisations decreased by 60 to 80%. The number and duration of episodes decreased, while there was an increase in the intercritical period. In other indications, valpromide has shown an effect on behavioral and personality disorders, associated to aggressivity and mood elation. It has also shown an effect on sleep disturbances. At the usual dosage of 600 to 1,200 mg per day (2 to 4 tablets) valpromide may be easily given on a long term treatment. Treatment should be progressively installed, particularly when combined with other CNS drugs, to prevent cognitive functions disturbances. The only absolute contra-indication is combination to carbamazepine. Controlled studies are currently being performed in manic depression (possible substitutive treatment to lithium) and in behavioural disorders with aggressivity.(ABSTRACT TRUNCATED AT 250 WORDS)