A pharmacokinetic and clinical evaluation of switching patients with bipolar I disorder from delayed-release to extended-release divalproex.

A pharmacokinetic and clinical evaluation of switching patients with bipolar I disorder from delayed-release to extended-release divalproex. Research Abstract Details 

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A pharmacokinetic and clinical evaluation of switching patients with bipolar I disorder from delayed-release to extended-release divalproex. Abstract Text:

Lori L Davis,Xiaohua Li,Al A Bartolucci,Raela B Williford,Joette S Lowe,

OBJECTIVE: To determine the optimal strategy for converting stable bipolar patients from twice-daily divalproex delayed release (DR) to once-daily divalproex extended release (ER). METHOD: This prospective, open-label, crossover study compared 4 divalproex regimens in euthymic outpatients with bipolar I disorder (DSM-IV diagnosis confirmed by Mini-International Neuropsychiatric Interview). Serum valproic acid levels were collected 12, 16, 20, and 24 hours after the last bedtime dose of the following regimens: DR twice daily (DR b.i.d.) during week 1; total daily DR dose once daily (DR q.h.s.) during week 2; once-daily ER at equal daily DR dose (ER 1:1) during week 3; and once-daily ER with the dose increased by 500 mg (ER + 500) during week 4. Patients continued on ER + 500 for 4 additional weeks after the pharmacokinetic phase. Side effects and psychiatric symptoms were assessed at weeks 1 through 4, 6, and 8. Twenty-one patients were enrolled from July 2002 to July 2004. RESULTS: Of the regimens tested, DR q.h.s. produced the widest fluctuations in valproic acid levels, with the highest 12-hour (82 mug/mL) and lowest 24-hour (44 mug/mL) levels. The ER + 500 dose was the only regimen that maintained the mean minimum valproic acid concentration above 50 mug/mL. Each regimen was well tolerated, and no significant changes in psychometric indices were observed. CONCLUSIONS: When converting stable bipolar patients from twice-daily divalproex DR to once-daily ER, we recommend increasing the total daily dose by 250 to 500 mg to ensure maintenance of therapeutic valproic acid levels.

A pharmacokinetic and clinical evaluation of switching patients with bipolar I disorder from delayed-release to extended-release divalproex. Publishing Authors By Initials

LL Davis,X Li,AA Bartolucci,RB Williford,JS Lowe,

For similar organic chemicals: carboxylic acids: acids, acyclic: valerates: pentanoic acids: valproic acid research abstracts see: organic chemicals: carboxylic acids: acids, acyclic: valerates: pentanoic acids: valproic acid research

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A pharmacokinetic and clinical evaluation of switching patients with bipolar I disorder from delayed-release to extended-release divalproex. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: The Journal of clinical psychiatry

VOLUME: 68

Page Numbers: 1546-51

Journal Abbreviation:

ISSN: 1555-2101

DAY: 19

MONTH: Oct

YEAR: 2007

A pharmacokinetic and clinical evaluation of switching patients with bipolar I disorder from delayed-release to extended-release divalproex. Information

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LANGUAGE: eng

NlmUniqueID: 7801243

A pharmacokinetic and clinical evaluation of switching patients with bipolar I disorder from delayed-release to extended-release divalproex. Keywords Mesh Terms:

KEYWORDS: Valproic Acid

MESH TERMS: therapeutic use

Chemical & Substance for Abstract: A pharmacokinetic and clinical evaluation of switching patients with bipolar I disorder from delayed-release to extended-release divalproex. Information

Substance Name: Valproic Acid

Registry Number: 99-66-1

Grant and Affiliation Information for A pharmacokinetic and clinical evaluation of switching patients with bipolar I disorder from delayed-release to extended-release divalproex.

AFFILIATION: Research and Development Department, Tuscaloosa VA Medical Center, Tuscaloosa, AL 35404, USA. lori.davis@va.gov

Country: United States

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MEDLINETA: J Clin Psychiatry

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