@entity308 is a common problem in the treatment of @entity162 . Only one, recently published, double-blind, placebo-controlled trial has examined the efficacy of divalproex in the prevention of @entity308 episodes in @entity162 @entity1 . This report describes, in further detail, the findings from that trial of the effect of divalproex on multiple dimensions of @entity308 in @entity162 . A randomized, double-blind, parallel-group, multicenter study was conducted over a 52-week maintenance period. @entity162 @entity1 , who may have been treated with open-label lithium or divalproex and who met recovery criteria within 3 months of onset of an index @entity162 , were randomized to maintenance treatment with divalproex, lithium, or placebo in a 2 : 1 : 1 ratio. Adjunctive paroxetine or sertraline for breakthrough @entity308 was allowed in maintenance phase. Outcome measures were the rate of early discontinuation for @entity308 , time to @entity308 , proportion of @entity1 with @entity308 , mean change in @entity308 Scale score, proportion of patients receiving antidepressants, and time in the study. Among @entity1 taking an antidepressant, a higher percentage of @entity1 on placebo than divalproex discontinued early for @entity308 . @entity1 who were previously hospitalized for affective episodes or took divalproex in the open period relapsed later on divalproex than on lithium during the maintenance period. Divalproex-treated @entity1 had less worsening of @entity308 symptoms than lithium-treated @entity1 during maintenance. Indices of severity of @entity221 course predicted worse outcome in all treatment groups. Divalproex improved several dimensions of @entity308 and reduced the probability of @entity308 in @entity162 , particularly in @entity1 who had responded to divalproex when @entity162 , and among @entity1 with a more severe course of @entity221 .

Maintenance efficacy of divalproex in the prevention of XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity162 :: ('MESH:D001714', 'Disease') :: ['manic', 'bipolar disorder', 'manic episode', 'Bipolar I', 'bipolar'] @entity308 :: ('MESH:D003866', 'Disease') :: ['Depressive Syndrome', 'depressive relapse', 'depressive morbidity', 'depression', 'depressive', 'Breakthrough depression'] @entity221 :: ('MESH:D005334', 'Disease') :: ['illness', 'prestudy illness']
@entity162 :: (MESH:D001714,Disease) :: ['bipolar depression']
