مقايسه سرعت پاسخدهي باليني در بيماران مانياي حاد به هنگام تجويز خوراكي والپروات سديم به روش بارگيري و روش تيتراسيون تدريجي

The Rate of Clinical Response of Oral Loading Sodium Valproate in Acutely Manic Patient

Introduction: Acheiving accelerated clinical response is desirable in patients with acute manic episode . We conducted a prospective study to compare the rate of clinical response of oral loading sodium valproate versus standard dose titration. Methods: Fourty - two patients who met DSM - 1V critevia for current manic episode and who had a "Young mania rating scale "score between 20 and 50 were randomly assigned on a double blind basis to recieve valproate oral loadingʹ (N=21) at a dose of 20 mg/kg in divided doses for 7 days and valproate "non - loading ʹ at a starting dose of 10mg/kg followed by standard titration which at day 6 , they recieved 20 mg/kg valproate. Patients were scored at day 0 , 3 , 5 and 7 by a blind rater using YMRS. Results: There was no significat differences between the groups in advers events and useing of adjunctive tranquilizer . The efficacy of valproate in both two groups was similar but " the rate of improvement on YMRSʹ over the first 3 days was significantly greater in loading group. Conclusion: Valproate oral loading with sodium valproate can induced a more rapid clinical response in acutely manic patient .