Divalproex sodium in sex offenders with bipolar disorders and comorbid paraphilias: an open retrospective study

• Published in: Journal of affective disorders Vol. 64; no. 2; pp. 249 - 255
• Main Authors: Nelson, Erik, Brusman, Lori, Holcomb, Jeff, Soutullo, Cesar, Beckman, Deanna, Welge, Jeffrey A., Kuppili, Naveen, McElroy, Susan L.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.05.2001; Elsevier
• Subjects: Adolescent; Adult; Antimanic Agents - administration & dosage; Antimanic Agents - therapeutic use; Biological and medical sciences; Bipolar Disorder - complications; Bipolar Disorder - drug therapy; Bipolar disorders; Divalproex; Humans; Male; Medical sciences; Neuropharmacology; Paraphilias; Paraphilic Disorders - complications; Pharmacology. Drug treatments; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Retrospective Studies; Sex offenders; Time Factors; Treatment Outcome; Valproic Acid - administration & dosage; Valproic Acid - therapeutic use; Divalproex; Sex offenders; Paraphilias; Bipolar disorders; Mood disorder; Human; Psychotropic; Treatment efficiency; Sexual behavior; Delinquency; Bipolar disorder; Valproate semisodium; Symptomatology; Concomitant disease; Chemotherapy; Treatment; Follow up study; Mood stabilizer; Mania; Sex offense; Social behavior disorder
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/S0165-0327(00)00255-X

Background: This study evaluated divalproex response in sex offenders with a bipolar disorder. Methods: We reviewed the records of all sex offenders who participated in a residential rehabilitative program who received divalproex for treatment of a bipolar disorder. Patients’ mood symptoms and, when present, comorbid paraphilic symptoms, were retrospectively assessed using the CGI severity scale. Results: Sex offenders displayed significant improvement in manic symptoms with divalproex treatment. However, there was no significant improvement in paraphilic symptoms in the subset of patients admitting to these symptoms. Conclusion: Divalproex may be effective for manic symptoms in sex offenders with a bipolar disorder. However, for bipolar sex offenders with comorbid paraphilias, the drug may not be effective for paraphilic symptoms. Limitations: This study was limited by its retrospective, open-label design, lack of systematic means of assessing manic and paraphilic symptoms, and small sample size. Clinical relevance: Divalproex may be a helpful adjunct in the treatment of the subset of sex offenders who have a bipolar disorder.