Editing Valproate (section)

===Mental illness===
Valproate products are used to treat manic or mixed episodes of [[bipolar disorder]].<ref name=":1">{{cite web |url=https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/valproate-information |title=Valproate Information |publisher=U.S. [[Food and Drug Administration]] (FDA) |access-date=24 April 2015 |url-status=dead |archive-url=https://web.archive.org/web/20150503091048/https://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm192645.htm |archive-date=3 May 2015 }}</ref><ref>{{cite journal | vauthors = Jochim J, Rifkin-Zybutz RP, Geddes J, Cipriani A | title = Valproate for acute mania | journal = The Cochrane Database of Systematic Reviews | volume = 2019 | issue = 10 | pages = CD004052 | date = October 2019 | pmid = 31621892 | pmc = 6797024 | doi = 10.1002/14651858.CD004052.pub2 }}</ref>

A 2016 [[systematic review]] compared the efficacy of valproate as an add-on for people with [[schizophrenia]]:<ref name=Wan2016>{{cite journal | vauthors = Wang Y, Xia J, Helfer B, Li C, Leucht S | title = Valproate for schizophrenia | journal = The Cochrane Database of Systematic Reviews | volume = 2016 | issue = 11 | pages = CD004028 | date = November 2016 | pmid = 27884042 | pmc = 6734130 | doi = 10.1002/14651858.CD004028.pub4 | url = http://www.cochrane.org/CD004028/SCHIZ_valproate-schizophrenia | url-status = dead | access-date = 27 July 2017 | archive-url = https://web.archive.org/web/20170729002449/http://www.cochrane.org/CD004028/SCHIZ_valproate-schizophrenia | archive-date = 29 July 2017 }}</ref>
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| There is limited evidence that adding valproate to [[antipsychotic]]s may be effective for overall response and also for specific symptoms, especially in terms of excitement and aggression. Valproate was associated with a number of adverse events among which sedation and dizziness appeared more frequently than in the control groups.<ref name=Wan2016/>
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! scope="col" style="text-align: left;"| Outcome
! scope="col" style="text-align: left;"| Findings in words
! scope="col" style="text-align: left;"| Findings in numbers
! scope="col" style="text-align: left;"| Quality of evidence
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! colspan="4" style="text-align: left;"| Global outcome
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| Clinically significant response||When added to antipsychotic drugs valproate probably increases the chance of improvement. Data are based on moderate quality evidence.
 || [[Relative risk|RR]] 1.31 (1.16 to 1.47) || [[The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach|Moderate]]
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| Leaving the study early for any reason || Valproate in combination with antipsychotics may slightly reduce the chance of leaving the study early, but the difference between the two treatments is not clear. Data supporting this finding are based on moderate quality evidence.
 || RR 0.76 (0.47 to 1.24) || [[The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach|Moderate]]
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| Use of additional medication for sedation|| The combination of valproate and antipsychotic drugs may increase the chance of being given additional sedating medication, but, at present it is not possible to be confident about the difference between the two treatments and data supporting this finding are very limited.
 || RR 3.65 (0.11 to 122.31) || [[The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach|Very low]]
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! colspan="4" style="text-align: left;"| [[Mental health|Mental state]]
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| Average score ([[Positive and Negative Syndrome Scale|PANSS]] total, high = poor)|| On average, people receiving the valproate combination scored lower (better) than people treated with antipsychotics in combination with placebo or antipsychotic drugs alone. There was a clear difference between the groups, but the meaning of this in day-to-day care is unclear. || [[Mean absolute difference|MD]] 5.85 lower (7.8 lower to 3.91 lower) || [[The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach|Moderate]]
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! colspan="4" style="text-align: left;"| [[Adverse event]]s
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| Abnormal liver function (blood test changes)* || Adding valproate to antipsychotic drug treatment does not clearly cause liver problems. Data supporting this finding are based on moderate quality evidence.
 || RR 1.26 (0.72 to 2.22) || [[The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach|Moderate]]
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| Nausea || Adding valproate to antipsychotic drugs probably causes little or no increase to the chance of feeling sick, but the difference between the two treatments is not clear. Data supporting this finding are based on moderate quality evidence.
 || RR 1.22 (0.80 to 1.86) || [[The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach|Moderate]]
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! colspan="4" style="text-align: left;"| Missing outcomes and notes
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| || [[Quality of life]] outcomes were not reported in the included studies. <br />*Increase in alanine transaminase/gamma-glutamyl transpeptidase ||  ||
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