TO EVALUATE THE RELATIONSHIP BETWEEN VALPROATE DOSE, SERUM VALPROATE CONCENTRATION, AND DOSE RATIO IN PATIENTS WITH BIPOLAR AFFECTIVE DISORDER

Dr. Sagar Kumar*; Dr. Madhulika Peter Samuel; Dr. Taskeen Tufail; Dr. Chandan Kumar

doi:10.64149/

Authors

Dr. Sagar Kumar* Assistant Professor1*, Department of Pharmacology, Naraina Medical College & Hospital, Kanpur, Uttar Pradesh, India Author
Dr. Madhulika Peter Samuel Professor2, Department of Pharmacology, Rama Medical College Hospital and Research Centre, Uttar Pradesh, India. Author
Dr. Taskeen Tufail PGT 3rd year3, Department of Biochemistry, Nalanda Medical College and Hospital, Patna, Bihar, India Author
Dr. Chandan Kumar Senior Resident4, Department of Anesthesiology, Lord Buddha Koshi Medical College and Hospital ,Saharsa, Bihar, India. Author

DOI:

https://doi.org/10.64149/

Keywords:

Bipolar affective disorder, Valproate, Serum concentration, Dose ratio, Therapeutic drug monitoring

Abstract

Background: Bipolar affective disorder (BPAD) is a chronic psychiatric illness requiring long-term pharmacotherapy. Valproate is widely used as a mood stabilizer due to its efficacy in acute mania and maintenance therapy. However, significant interindividual variability exists in serum valproate concentrations at similar doses, necessitating therapeutic drug monitoring (TDM).

Aim: To evaluate the relationship between valproate dose, serum valproate concentration, and dose ratio in patients with bipolar affective disorder.

Materials and Methods: This observational study included 65 patients diagnosed with BPAD receiving valproate therapy. Data on demographic variables, daily valproate dose, and serum valproate levels were collected. Dose ratio (serum concentration/dose) was calculated. Correlation analysis was performed to assess relationships between variables.

Results: The mean valproate dose was 912.3 ± 248.5 mg/day, and the mean serum valproate concentration was 68.4 ± 18.7 µg/mL. A majority of patients (63.1%) achieved therapeutic serum levels. A moderate positive correlation was observed between dose and serum concentration (r = 0.62, p < 0.001). Dose ratio showed a weak-to-moderate correlation with serum levels (r = 0.34, p = 0.006), indicating pharmacokinetic variability. Wide interindividual variation was observed even at similar doses.

Conclusion: Valproate exhibits significant interindividual variability in serum levels relative to dose. Therapeutic drug monitoring and individualized dosing strategies are essential for optimizing treatment outcomes in BPAD patients.