Symptomatic response to divalproex in subtypes of conduct disorder.
Author(s): Padhy R, Saxena K, Remsing L, Huemer J, Plattner B, Steiner H.
Affiliation(s): Department of Psychiatry, UCLA, Los Angeles, CA, USA. padhyscapa@hotmail.com
Publication date & source: 2011, Child Psychiatry Hum Dev. , 42(5):584-93
To investigate response to Divalproex sodium (DVPX) with respect to
Reactive/Affective/Defensive/Impulsive (RADI) and
Proactive/Instrumental/Premeditated (PIP) aggression among adolescent males with
conduct disorder (CD), using results from a randomized, double-blind,
placebo-controlled trial. It was hypothesized that DVPX response among
participants with RADI aggression would be greater than among those with PIP
aggression. Fifty-eight ethnically diverse males with severe CD were assigned to
High Distress (HDCD) or Low Distress (LDCD) Conduct Disorder, corresponding with
RADI and PIP aggression, respectively. Following a 1-week washout, all subjects
were randomized to a high dose (up to 1,500 mg/day) or low dose (up to
250 mg/day) of DVPX. Baseline and endpoint assessments included Clinical Global
Impression (CGI), Achenbach Self Report (YSR), and Weinberger Adjustment
Inventory (WAI-62). Response to DVPX was significantly higher in the HDCD group
(64%) than in the LDCD group (22%) in the high-dose treatment group (p = 0.03).
Mean weekly WAI-62 distress scores declined significantly among the HDCD subjects
than among LDCD subjects in the high-dose group. These results support the
utility of mood stabilizing agents such as DVPX in treating patients with
disorders characterized by the RADI pattern of aggression, including those with
severe CD.
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