Agitation as a Paradoxical Effect of Divalproex Sodium: A Case Report
TLDR Divalproex sodium can unexpectedly cause agitation and hyperactivity in some patients.
In 2001, a case report was presented about a 39-year-old man with a history of schizoaffective disorder, cocaine and cannabinoid dependence, and noncompliance with medications. The patient was treated with divalproex, a drug approved by the U.S. Food and Drug Administration for the treatment of seizures and bipolar I disorder. The patient experienced a rare paradoxical effect of increased hyperactivity, hostility, and behavioral deterioration when the dose of divalproex was increased. This led to the hypothesis that these adverse effects might be associated with the increased dose of divalproex. When divalproex was discontinued, the patient became calmer, less restless, less impulsive and irritable, and more pleasant and cooperative. The report concluded that while it was not certain if divalproex was solely responsible for the agitation, physicians should be alert to the possibility of behavioral deterioration induced by this medication.
