In older adults with dementia, are sodium valproate and other anticonvulsants more effective than antipsychotics, for reducing agitation and excessive activity or 'drive'?
No definite clinical implications can be made from the available
evidence. It does not appear that any studies have directly
compared sodium valproate or other anticonvulsants with
antipsychotics. Most of the studies evaluated have compared
anticonvulsants with placebo.
There is a common theme in the literature - that there is
limited evidence on the use of anticonvulsants, both in terms of
number of studies, and in terms of the methodological quality of
the available studies. In addition, many of the treatments were
associated with problematic side effects, prompting some authors to
suggest that they should be used with caution. There is also a lack
of evidence specifically on valproate, and review authors have
suggested that this treatment may not be recommended for the
first-line treatment of demented patients with agitation.
All review authors suggested that more research is needed in
this area, and most mentioned the need for the further development
of safe and effective pharmacological and non-pharmacological
interventions for patients with dementia.
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