{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T05:45:15Z","timestamp":1780983915971,"version":"3.54.1"},"reference-count":35,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[1998,2,1]],"date-time":"1998-02-01T00:00:00Z","timestamp":886291200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can J Psychiatry"],"published-print":{"date-parts":[[1998,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine the efficacy of divalproex sodium in the treatment of psychiatric outpatients with treatment refractory panic disorder and comorbid mood instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>This was an 8-week, open-trial, flexible-dose outcome study conducted at a tertiary care referral centre. Individuals with panic disorder who failed to respond to a cognitive behavioural treatment program and standard antipanic medication, who also suffered from mood instability, were chosen to participate in the study. Divalproex sodium was administered at a flexible dose to reach serum levels of 300 to 600 umol\/L (45 to 90 ug\/ml) unless limited by tolerance. Patients were rated by self- and rater-administered questionnaires that measured the number of panic attacks, the degree of agoraphobic avoidance, the levels of depression, anxiety, and mood swings, and the perceived sense of well being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Thirteen subjects were enrolled in the study, and 10 subjects completed it. Two dropped out early because of the medication's side effects, and 1 was lost within the first month of follow-up. All 10 subjects showed significant improvement in depressive and anxiety symptoms and mood instability. There was also a statistically and clinically significant improvement in panic attacks and measures of quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>These findings suggest that divalproex sodium is useful in the treatment of patients with panic disorder and concomitant mood instability, who are refractory to conventional treatment. Double-blind trials will be required to verify these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/070674379804300109","type":"journal-article","created":{"date-parts":[[2017,1,11]],"date-time":"2017-01-11T17:20:00Z","timestamp":1484155200000},"page":"73-77","source":"Crossref","is-referenced-by-count":67,"title":["Efficacy of Divalproex Sodium in Patients with Panic Disorder and Mood Instability Who Have Not Responded to Conventional Therapy"],"prefix":"10.1177","volume":"43","author":[{"given":"Marilyn","family":"Baetz","sequence":"first","affiliation":[{"name":"Resident IV, Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudradeo C","family":"Bowen","sequence":"additional","affiliation":[{"name":"Professor of Psychiatry, Department of Psychiatry, University of Saskatchewan, Saskatoon, 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