EFFICACY OF VALPROATE MAINTENANCE IN BIPOLAR ALCOHOLICS

Project: Research project

Project Details

Description

We propose to test the efficacy of sodium valproate in the acute and early
maintenance phases of treatment for patients with alcoholism and comorbid
bipolar disorder in a double-blind, placebo-controlled, and randomized,
parallel group trial. With nearly one million affected individuals in the
U.S., comorbid alcoholism and bipolar disorder in a double-blind, placebo-
controlled, and randomized, parallel group trial. With nearly one million
affected individuals in the U.S., comorbid alcoholism and bipolar disorder
represent a significant public health challenge. The presence of
comorbidity has a significant public health challenge. The presence of
comorbidity has a significant negative impact on treatment response and
outcome resulting in increased risk for suicide, and increased rates of
costly inpatient psychiatric care. Pharmacologic treatment addressing
concurrently these dual disorders is non-existent. Our proposed
intervention is based on Past and coworkers theoretical model of kindling
and behavioral sensitization hypothesized to underlie the mechanisms of
both the recurrent and progressive course of bipolar illness and that of
alcohol withdrawal/craving states. This model has formed the basis for
the successful use of anti-convulsant, anti-kindling agents in the
treatment of bipolar disorders and its applicability to bipolar alcoholics
is highly relevant. We request five years of support to achieve the
following aims: 1) Examine the efficacy of sodium valproate plus a
procedurally specified Treatment-As-Usual (TAU = lithium carbonate +
counseling) condition compared to a placebo plus TAU in the stabilization
of acute manic episodes in patients with comorbid DSM-IV alcohol
dependence; 2) Assess specific predictors of medication response, and; 3)
Conduct a prospective assessment of the effects of the severity of alcohol
use on mood symptoms. Ninety-four subject (n=47 for each group) will be
recruited, randomized and stabilized on pharmacotherapy on the inpatient
units and prospectively followed, with biweekly assessment, for 6 months
of outpatient care. This research is likely to lead to more effective
pharmacologic treatment of patients with alcoholism and bipolar disorders
and help to increase our knowledge of predictors of treatment response in
this high risk clinical population.
StatusFinished
Effective start/end date3/1/962/28/02

Funding

  • National Institute on Alcohol Abuse and Alcoholism
  • National Institute on Alcohol Abuse and Alcoholism
  • National Institute on Alcohol Abuse and Alcoholism
  • National Institute on Alcohol Abuse and Alcoholism: $107,180.00
  • National Institute on Alcohol Abuse and Alcoholism

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