Abstract
Ten patients (6 females and 4 males) suffering from an acute manic episode assessed by the “Echelle d’Intensité Maniaque” (E.I.M. or Manic Intensity Scale) in the context of bipolar disorder (n = 7) or schizoaffective disorder bipolar type (n = 3) (DSM IV and Diagnostic Interview for Genetic Studies) were treated with valproate as a first line of treatment (plasma level between 50 and 100 mg/l). Six out of ten patients presented a reduction of more than 50% of their initial score for mania after one week and 7 out of 10 patients after 15 days. Valproate was revealed to be efficient and was very well tolerated which favoured good treatment compliance. Only gastro-intestinal side effects as well as transient thrombocytopenia were observed. A resistance factor to valproate was the presence of mood-incongruent psychotic features.