Background: Selection of appropriate pharmacotherapy for psychotic patients who exhibit dangerousness is an important issue. Divalproex is a fast-acting agent which appears to be safe and effective in such circumstances. The objective of the following inpatient study was to investigate divalproex as a pharmaceutical adjunct in treating agitated and/or violent, psychotic schizophrenic subjects.

Methods: For the purpose of comparison, 147 hospitalized patients were separated into violent (n = 60) and non-violent (n = 87) groups. In addition to antipsychotic drugs given to all subjects, divalproex was preferentially prescribed for the more dangerous patients (n = 40). The clinical status of demographics and parameters related to dangerousness in all participants was assessed to document differences during these admissions and for rehospitalization over one year.

Results: Divalproex was well tolerated; however, one individual developed a transient granulocytopenia. Its use in agitated and/or violent psychotic persons appears to have included a calmer, less dangerous hospital course, like that observed among their less disruptive counterparts.

Conclusions: Divalproex seemed to have been helpful in this study at facilitating a more routine hospital course for agitated psychotic patients, similar to that of less overtly disturbed individuals. No significant adverse events were observed. The validity of this study is limited by its retrospective, uncontrolled nature.

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