Association of chronic divalproex sodium use and brain atrophy in Alzheimer's disease

Abstract

Evaluation of: Fleisher AS, Truran D, Mai JT et al. Chronic divalproex sodium use and brain atrophy in Alzheimer disease. Alzheimer's Disease Cooperative Study. Neurology 77(13), 1263-1271 (2011). Divalproex sodium has been widely use for the treatment of bipolar disorder, behavioral control in schizophrenia, seizure and agitation in Alzheimer's disease. With the advent of other mood stabilizers and anticonvulsants, the use of divaplroex sodium has been slightly decreased; however, it has been a major mediation for the treatment of such medical conditions. Beyond symptomatic effects on such neuropsychiatric conditions, it has also been proposed to hold some neurotoxicity effects, including reversible brain atrophy (which may be a serious complication associated with substantial cognitive decline), although it has shown neuroprotective effects. Common adverse events include sedation, tiredness and gastrointestinal symptoms. According to a recent study, divalproex treatment was associated with accelerated brain volume loss over 1 year, which could possibly lead to greater cognitive impairment. Hence, this article will discuss clinical and further research implications of this study, as well as the potential limitations and significance of the research.