Efficacy of Sodium Valproate in Behavioral and Psychological Symptoms of Dementia: A Retrospective Observational Study from PUMCH Dementia Cohort.

Abstract

Introduction: Behavioral and Psychological Symptoms of Dementia (BPSD) pose significant challenges for individuals with dementia and their caregivers. Agitation symptoms, in particular, present a complex management dilemma as there is a lack of consensus regarding pharmacotherapy, specifically with respect to the controversial use of valproate formulations. This study aims to assess the effectiveness of valproate treatment in addressing BPSD, with a specific focus on managing agitation symptoms in individuals with dementia.

Methods: A retrospective analysis was conducted at Peking Union Medical College Hospital (PUMCH) on patients diagnosed with BPSD who received valproate formulations between 2013 and 2023. Patients were classified into 'effective,' 'ineffective,' and 'unknown' groups based on their response to valproate treatment, and the distribution of BPSD symptoms between the effective and ineffective groups was compared.

Results: Among the 116 patients studied, 62.1% exhibited effective responses, 12.1% showed ineffectiveness, and 25.9% had uncertain outcomes with valproate therapy. While the effective group displayed a higher prevalence of agitation symptoms and other behaviors like wandering, restricted and repetitive behaviors, and sleep disturbances compared to the ineffective group, these differences did not reach statistical significance (p = 0.156, 1.000, 0.899, 0.283). Patients in the ineffective group were more likely to experience aggression with comorbid psychotic symptoms compared to those in the effective group (p = 0.023).

Conclusion: The findings suggest that tailored valproate treatment at low doses may be beneficial in managing agitation without psychosis in Asian BPSD patients. Further validation through randomized controlled trials is essential to substantiate these observations.