TY  - JOUR
PY  - 2019//
TI  - Divalproex and its effect on suicide risk in bipolar disorder: a systematic review and meta-analysis of multinational observational studies
JO  - Journal of affective disorders
A1  - Chen, Tien-Yu
A1  - Kamali, Masoud
A1  - Chu, Che-Sheng
A1  - Yeh, Chin-Bin
A1  - Huang, San-Yuan
A1  - Mao, Wei-Chung
A1  - Lin, Pao-Yen
A1  - Chen, Yen-Wen
A1  - Tseng, Ping-Tao
A1  - Hsu, Chung-Yao
SP  - 812
EP  - 818
VL  - 245
IS  - 
N2  - BACKGROUND: Divalproex has become the most prevalent mood stabilizer for bipolar disorder. However, little is known its effects in the prevention of suicide in patients with bipolar disorder, and recent FDA announcement indicated an increased risk of suicidality when using anti-epileptic agents such as divalproex. The aim of this study is to investigate the effect of divalproex on suicide risk in patients with bipolar disorder. <br><br>METHODS: A search strategy was used for the PubMed, Embase, ProQuest, ScienceDirect, Cochrane Library, ClinicalKey, Web of Science, and ClinicalTrials.gov until June 13th, 2018. Peer-reviewed observationally clinical studies in humans, investigating the association of divalproex and suicidality in patients with bipolar disorder were included. A random-effects meta-analysis was implemented to calculate the relative risk (RR) and 95% confidence intervals (CIs) for suicidality among patients receiving divalproex and those without. <br><br>RESULTS: Total 6 studies were included in the final meta-analysis. There was no significant difference in the incidence rates (reported as [RR]; 95% CI) of suicide attempts (0.921; 0.383-2.215) or completed suicides (0.607; 0.180-2.043) between participants receiving divalproex vs. no medication. There was no significant difference in the incidence rates of suicide attempts (0.815; 0.453-1.466) or completed suicides (1.009; 0.410-2.484) between participants receiving divalproex and carbamazepine. LIMITATIONS: The significantly heterogeneous sample sources and study design amount the included trials. <br><br>CONCLUSIONS: Treatment with divalproex did not reduce or increase the incidence of suicide-related events in patients with bipolar disorder.<br><br>Copyright © 2018 Elsevier B.V. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0165-0327
UR  - http://dx.doi.org/10.1016/j.jad.2018.11.093
ID  - ref1
ER  -