Combination lithium and divalproex sodium in pediatric bipolar symptom restabilization

Robert L. Findling, Nora K. McNamara, Robert Stansbrey, Barbara L. Gracious, Resaca E. Whipkey, Christine A. Demeter, Michael D. Reed, Eric A. Youngstrom, Joseph R. Calabrese

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


Objective: It has been reported that bipolar disorder may become less responsive to previously effective treatment with each symptomatic relapse. The primary goal of this study was to assess the rate of restabilization after the resumption of lithium (Li+) plus divalproex (DVPX) following relapse on either agent as monotherapy. Method: This is a prospective, 8-week, open-label outpatient Li+/DVPX combination therapy trial. Patients ages 5 to 17 years with bipolar disorder type I or II, who had achieved symptom remission with Li+/DVPX combination therapy and subsequently relapsed during treatment with Li+ or DVPX monotherapy were enrolled between January 1999 and January 2003. Results: Thirty-eight patients with a mean age of 10.5 years entered the study. Thirty-four (89.5%) patients responded to treatment with Li+/DVPX mood stabilizer therapy alone, but four patients required adjunctive antipsychotic treatment to address residual symptomatology. Overall, reinitiation of Li+/DVPX combination therapy was well tolerated with no subjects discontinuing because of a medication-related adverse event. Conclusions: It appears that most youths with bipolar disorder who stabilize on combination Li+/DVPX therapy and subsequently relapse during monotherapy can safely and effectively be restabilized with the reinitiation of Li+/DVPX combination treatment.

Original languageEnglish (US)
Pages (from-to)142-148
Number of pages7
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number2
StatePublished - Feb 2006
Externally publishedYes


  • Bipolar disorder
  • Divalproex sodium
  • Lithium
  • Treatment

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'Combination lithium and divalproex sodium in pediatric bipolar symptom restabilization'. Together they form a unique fingerprint.

Cite this