This double-blind, randomized, multicenter study investigated the use of divalproex with an antipsychotic agent in patients hospitalized for acute exacerbation of schizophrenia. Patients (n = 249) who met DSM-IV criteria for schizophrenia were randomly assigned toreceive olanzapine monotherapy, risperidonemonotherapy, divalproex plus olanzapine, or divalproex plus risperidone for 28 days.Divalproex was initiated at 15 mg/kg/day and titrated over 12 days to a maximum dosage of 30 mg/kg/day. Olanzapine and risperidone, were, respectively, initiated at 5 and 2 mg/day and were titrated over the first 6 days to respective target fixed daily dosages of 15 and6mg/day. Improvements from baseline were observed at allevaluation points throughout the 28-day treatment period in the twocombination therapy and the two antipsychotic monotherapy groups, with statistically significant treatment differences favoringcombination therapy as soon as day 3 for Positive and Negative Syndrome Scale (PANSS) totalscore, derived Brief Psychiatric RatingScale (BPRSd) totalscore, as wellas PANSS and BPRSd subscales. These findings were confirmed inpost hocrepeated-measures analysesof variance in which treatment differences favoring combination therapy were observed for PANSS total (p = 0.020) and PANSS positivescale scores (p = 0.002). Both combination therapy and antipsychotic monotherapy were welltolerated. Treatment with divalproex incombination with an atypicalantipsychotic agent resulted in earlier improvements in a range of psychotic symptoms among acutelyhospitalized patients with schizophrenia. Further evaluation is warranted to confirm these findings.
ASJC Scopus subject areas
- Psychiatry and Mental health