Sodium Valproate as an Adjunctive Drug in Treatment of Schizophrenia

Objective: Although sodium valproate came to the market as an anticonvulsant drug, nowadays it's wildly used in the management of psychiatric disorders. It is used as a mood stabilizer and as an adjunctive agent in treatment of depression and psychosis. There are controversies regarding sodium valproate efficacy in psychosis. Although some studies have reported that it is effective in the management of positive symptoms and aggression in acute psychosis, others have not found such an association. Our study aims to investigate the effects of adjunctive sodium valproate in the pharmacological management of patients with schizophrenia.

Method: In a double blind clinical trial, 32 schizophrenic patients (age 18 65), who were in immediate need of admission, were randomly allocated into two groups. The first group was treated by combination of sodium valproate and risperidone and the other by combination of placebo and risperidone. A diagnosis of schizophrenia was established based on DSM-IV-TR criteria. All patients were assessed by PANSS on the 1 st , 14th and 28th days of the admission. The collected data were analyzed by Student and Paired T tests through SPSS.

Results: Comparison of PANSS mean score in two groups, before and after the trial, showed statistically significant differences. The reduction in PANSS score was significantly higher in the group treated with sodium valproate than in placebo group (P= 0.006). Although, there was a statistically significant reduction in positive symptoms in both group after 2 weeks of treatment (P= 0.048), the difference was not significant in the fourth week (P= 0.88)

Conclusion: Our study shows that if used as an adjunct to antipsychotic in the management of acute psychosis, sodium valproate will speed up the recovery of positive symptom