Safe use of sodium valproate

摘要

Editor, - Your article on the safe use of sodium valproate (Aust Prescr 2014;37:124-7) is an excellent brief summary on the drug's pharmacology and uses. However, the authors have omitted to mention its use in corticosteroid-induced mania.1 Corticosteroids in high doses are used in many conditions but cause many dysphoric symptoms, including hypomania, panic, confusion and insomnia, all of which are described as unpleasant.2 In the past, treatment had to be stopped and symptoms controlled by major tranquillisers. Our work describing 20 case studies of steroid-induced mania coming to the attention of a consultation-liaison team have shown that sodium valproate can rapidly reduce manic-like symptoms while treatment with corticosteroids continued. We think that this is a worthwhile point which should be brought to the attention of your readers.