Efficacy of divalproex therapy for schizoaffective disorder

Schizoaffective disorder is a common, severe, and lifelong illness; however, little is known about the pharmacologic treatment of this mental disorder. Divalproex has proven efficacy in the treatment of bipolar disorder. Therefore, to determine whether divalproex is also effective as adjunctive therapy for schizoaffective disorder, the authors performed a retrospective study of 20 patients in the public mental health system with schizoaffective disorder, bipolar type, who initiated divalproex therapy. The mean maximum dose of divalproex (±1 SD) was 1,150 mg (±400 mg; range, 500-2,000). The mean peak serum valproic acid level was 61 μg/mL (±25 μg/mL; range, 20-92). The overall improvement in Clinical Global Impression Scale scores was observed in 75% (15/20) of the patients (p = 0.0001). None in the sample worsened, and none discontinued divalproex because of side effects. These data suggest that divalproex is well-tolerated and effective as treatment of persistent schizoaffective disorder, bipolar type. Thus, divalproex may be an effective agent in the treatment of schizoaffective disorder as well as bipolar disorder. Controlled prospective trials in patients with schizoaffective disorder are needed to verify these findings.