Divalproex treats bipolar depression?

(added 3/2015)

Does valproate (divalproex) treat bipolar depression?

In general, most practitioners do not seem to think so.  Nor do I. Well, not until I saw this “meta-analysis”. That’s the name for a review of previous studies that uses all the results pooled together. Sometime you can see a small signal that way, when each individual study was “negative”, meaning it showed no difference from placebo.

Valproate, the active ingredient in divalproex, might have some benefit in bipolar depression, according to this meta-analysis. You can see that effect in this graph:

valproate depression

The big black diamond is just slightly to the left of the vertical line, which means that valproate is indeed just slightly better than a placebo in the treatment of bipolar depression.Smith