In order to explore valproate's spectrum of efficacy in rapid-cycling
bipolar disorder, 55 patients underwent a prospective, open, 7.8-month
trial designed to assess the drug's acute and prophylactic properties.
Twenty patients received monotherapy, and 35 received combination therapy.
Moderate to marked acute antidepressant responses were seen in 47% of the
patients, prophylactic antidepressant responses in 76%, acute antimanic
responses in 91%, prophylactic antimanic responses in 94%, acute responses
in mixed states in 85%, and prophylactic responses in mixed states in 93%.
Consistent with other anticonvulsant literature, these data suggest that
valproate has marked antimanic and mixed state efficacy, but minimal to
moderate antidepressant properties.