An Open Trial of Divalproex Sodium in Autism Spectrum Disorders
J Clin Psychiatry 2001;62(7):530-534
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Autism spectrum disorders are
characterized by core deficits in social interaction and
speech/communication skills, repetitive behaviors, and restricted
interests. Other abnormalities include seizures,
electroencephalographic (EEG) abnormalities, affective
instability, impulsivity, and aggression. Divalproex sodium is
indicated as both an anticonvulsant in epilepsy and a mood
stabilizer in bipolar illness and thus might be useful for these
complicating symptoms in autism.
Method: A retrospective pilot study was
conducted to determine whether divalproex sodium was effective in
treating core dimensions and associated features of autism.
Fourteen patients who met DSM-IV criteria for autism, Asperger's
disorder, or pervasive developmental disorder not otherwise
specified, both with and without a history of seizure disorders
or EEG abnormalities, were openly treated with divalproex sodium.
Improvement was assessed via the Clinical Global
Results: Of 14 patients who completed a trial of
divalproex sodium, 10 (71%) were rated as having sustained
response to treatment. The mean dose of divalproex sodium was 768
mg/day (range, 125-2500 mg/day), and it was generally well
tolerated. Improvement was noted in core symptoms of autism and
associated features of affective instability, impulsivity, and
Conclusion: Divalproex sodium may be beneficial
to patients with autism spectrum disorders, particularly those
with associated features of affective instability, impulsivity,
and aggression as well as those with a history of EEG
abnormalities or seizures. Of note, all patients with an abnormal
EEG and/or seizure history were rated as responders. However,
these findings must be interpreted with caution, given the open
retrospective nature of the study. Controlled trials are needed
to replicate these preliminary findings.