Treatment guidelines for valproate in bipolar and schizoaffective disorders.

An increasing number of uncontrolled and controlled studies have shown that the anticonvulsant drug valproate is effective for the acute and prophylactic treatment of some patients with bipolar disorder, including those who respond inadequately to or cannot tolerate treatment with lithium or carbamazepine. Uncontrolled studies suggest that valproate may be effective in some patients with schizoaffective disorder. In this article, studies of the efficacy of valproate for the treatment of bipolar and schizoaffective disorder are briefly reviewed, and clinical guidelines for its use in these patients are presented.