Posted by SalArmy4me on August 8, 2001, at 10:04:42
In reply to Depakote = panic attacks??, posted by MM on August 8, 2001, at 2:46:11
Usually Depakote is really good for panic disorder. Maybe you need a higher dosage:
Year Book of Psychiatry and Applied Mental Health
Volume 1999(8) Annual 1999 pp 353-354
Efficacy of Divalproex Sodium in Patients With Panic Disorder and Mood Instability Who Have Not Responded to Conventional Therapy:Introduction.-Individuals with panic disorder often experience depressive symptoms as well, and their response to treatment is poorer than that of patients with panic disorder alone. An 8-week trial was conducted to determine the efficacy of divalproex sodium in the treatment of patients with panic disorder refractory to conventional therapy and co-morbid mood instability.
Methods.-Patients in the open trial, flexible dose study received divalproex sodium at 250 mg twice daily, increased by 250 mg increments to reach serum levels of 300 to 600 [micro sign]mol/L. Assessments were conducted at baseline, at 4 weeks, and at 8 weeks by self- and rater-administered questionnaires.
Results.-Ten patients, 6 women and 4 men, completed the study. The mean age of the group was 43.9 years, and the mean duration of panic disorder was 19.3 years. All patients had previously been treated by a psychiatrist and had taken several antidepressants and benzodiazepines in the past. All had panic disorder and symptoms of mood instability; 7 had agoraphobia. Divalproex sodium brought about significant improvement in depressive and anxiety symptoms and mood instability. The average number of panic attacks decreased from 4.3 full attacks and 4 limited attacks weekly to 1.5 full attacks and 1.0 limited attack at the end of the 8-week study, a statistically significant and clinically important change. By week 8, 80% of patients reported being much or very much improved.
Conclusion.-Divalproex sodium proved useful in the treatment of patients with panic disorder and concomitant mood instability. All patients had failed to respond to the standard treatment of antidepressants and cognitive behavioral therapy.
This interesting case series from Canadian researchers is 1 of several suggesting that valproic acid may be useful for panic disorder. Although this, in itself, is not much in the way of news, the growing evidence that there is an interface between bipolar disorder and panic disorder is of clinical significance. This is where an anticonvulsant mood stabilizer may play an important therapeutic role. Many panic patients talk about mood swings (and it is easy to dismiss this as something related to their disorder) when, in fact, they may be describing bipolar disorder type II symptoms. As the authors noted, a double-blind study is indicated to test this possibility further. Interestingly, there was a recent study of cocaine abusers who were treated with carbamazepine; those with "mood spectrum" symptoms in addition to the cocaine abuse did better with carbamazepine treatment overall than did those patients who did not have any evidence of a mood disorder.
poster:SalArmy4me
thread:74094
URL: http://www.dr-bob.org/babble/20010804/msgs/74131.html