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Desval (Divalproex)
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Divalproex

Desval was the first antiepileptic drug studied as a mood stabilizer in the 1960s. It is believed to block the catabolism of the inhibitory neurotransmitter GABA, to increase its release, and to increase GABAB receptor density. Its popularity in adult bipolar treatment translated into wide use in children and adolescents, yet there have been no published, adequately powered, prospective, double-blind, placebo-controlled studies of Desval in pediatric bipolar disorder. Case reports, positive open trials, and retrospective chart reviews make up the bulk of the evidence on which this practice is built. In a randomized comparison of lithium, Desval, and carbamazepine, all three agents were judged effective in a study of 8- to 14-year-olds with bipolar disorder (Kowatch et al, 2000). Nausea and sedation were the only adverse effects reported in the Desval arm of the study, in which the target dose was 20 mg/kg/day.Carbamazepine, thought to inhibit neuronal voltage-dependent sodium channels, is less well studied in pediatric bipolar disorder. In the Kowatch trial, response rates were relatively lower for carbamazepine; the common adverse effects of nausea, dizziness, rash, and sedation occurred at the target serum level of 9 to 11 μg/L. Oxcarbazepine, an analogue of carbamazepine, failed to show efficacy in a large, double-blind RCT of 7- to 18-year-olds with bipolar disorder.

Other names for this medication:
Divalproex, Depakote, Dicorate, Divaa, Desval,

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