This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s Terms & Conditions.

Original Research

Divalproex Sodium for the Treatment of Conduct Disorder: A Randomized Controlled Clinical Trial

Hans Steiner, MD; Maya L. Petersen, BA; Kirti Saxena, MD; Sekou Ford, MD; and Zakee Matthews, MD

Published: October 15, 2003

Article Abstract

Background: New treatments for conduct disorder are sorely needed. We aimed to test the efficacy of divalproex sodium for the treatment of conduct disorder.

Method: Seventy-one youths with conduct disorder according to DSM-IV criteria were enrolled in a randomized, controlled, 7-week clinical trial. Subjects were all adolescent males with at least 1 crime conviction. Subjects were randomized into high- and low-dose conditions and were openly managed by a clinical team. Subjects and independent outcome raters were blinded to condition. Clinical Global Impressions-Severity of Illness (CGI-S) and CGI-Improvement (CGI-I) ratings, Weinberger Adjustment Inventory ratings, and staff ratings of behavioral privilege were used to assess outcome.

Results: Intent-to-treat analyses showed significant associations between assignment to the high-dose condition and ratings on the CGI-S (p = .02) and CGI-I (p = .0008). Self-reported weekly impulse control was significantly better in the high-dose condition (p < .05), and association between improvement in self-restraint and treatment condition was of borderline statistical significance (p < .06). Parallel analyses comparing outcome by blood drug level achieved strengthened the results, as expected.

Conclusion: This preliminary study in a most difficult population suggests a role for divalproex sodium in the treatment of conduct disorder. Divalproex sodium improved self-reported impulse control and self-restraint, variables shown to be predictive of criminal recidivism. Studies are needed of longer-term impact and side-effect profiles. This is one of few controlled psychopharmacologic studies of conduct disorder.

Volume: 64

Quick Links: Child and Adolescent , Populations

Continue Reading…

Subscribe to read the entire article

$40.00

Buy this Article as a PDF