{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T23:19:03Z","timestamp":1778800743623,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T00:00:00Z","timestamp":1629331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Context:<\/jats:title>\n                    <jats:p>Antipsychotics and benzodiazepines do not improve delirium. Valproic acid (VPA) has been used recently to treat agitation in delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To review the evidence for VPA in the management of Delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Systematic review. English language, age 19 and above, from 1946 to January 12, 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Mesh Terms:<\/jats:title>\n                    <jats:p>\u201cValproic acid\u201d, \u201cvalproate\u201d, \u201csodium valproate\u201d, \u201cdelirium\u201d, \u201cacute mania with delirium\u201d in PubMed and Ovid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exclusion:<\/jats:title>\n                    <jats:p>Studies of VPA used for diagnoses other than delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>21 abstracts were identified and 10 studies were included in the review (252 patients): One prospective open label study (n: 7), 2 case series (n: 22), 4 retrospective studies (n: 219) and 3 case reports (n: 4). No randomized controlled trial (RCT) evaluates the effect of VPA in delirium. 237\/250 (94.8%) patients were in the ICU. Mean age was 59.7 (27-87). 153\/204 (74%) were male. The mean starting dose was 733 mg\/day in 148 patients and the mean dose at follow up was 1061 mg\/day in 205 patients. CAM ICU was used to diagnose delirium in 6 reviews. Delirium improved in case series in 19\/22 patients. Delirium improved in retrospective studies at day 3 compared to day 1. VPA levels were not consistently reported. Hyperammonemia (12-19%) and thrombocytopenia (9-13%) were the most common side effects. No deaths were attributed to VPA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>VPA is being used more frequently for delirium. The evidence is limited to retrospective studies and case series. There is a need for RCT to evaluate the effect of VPA in delirium compared to other alternatives and placebo.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091211038371","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T05:28:20Z","timestamp":1629350900000},"page":"562-569","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Valproic Acid in the Management of Delirium"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5561-6211","authenticated-orcid":false,"given":"Carlos Fernandez","family":"Cuartas","sequence":"first","affiliation":[{"name":"Geisinger Medical Center, Danville, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7903-3993","authenticated-orcid":false,"given":"Mellar","family":"Davis","sequence":"additional","affiliation":[{"name":"Geisinger Medical 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