Leo Sher, M.D.
A research paper, “Divalproex and its effect on suicide risk in bipolar disorder: A systematic review and meta-analysis of multinational observational studies” has recently been published in the Journal of Affective Disorders (1).
In general, studies on the effect of divalproex on suicide risk in patients with bipolar disorder have produced conflicting results. The authors used random-effects meta-analysis to calculate the relative risk and 95% confidence intervals for suicidality among patients receiving divalproex and those without. Six studies were included in the final meta-analysis (2-7). Four studies compared the suicidal risks between treatment with divalproex and no medication treatment (2-5) and four studies compared the suicidal risks between divalproex and carbamazepine (4-7). The clinical variables of interest were extracted from each study according to a predetermined list.
The authors did not find significant difference in the incidence rates of suicide attempts or suicide death between study participants receiving divalproex vs. no medication. The authors also did not observe significant difference in the incidence rates of suicide attempts or suicide death between participants receiving divalproex and carbamazepine. The authors noted that their results are consistent with previous findings indicating that divalproex does not increase the risk of suicide events in bipolar patients.
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