The effect of sodium valporate on the treatment of opium withdrawal patients

Background: Gamma-amino butyric acid (GABA) agonists have been effective in the treatment of withdrawal from benzodiazepines, sedatives and alcohol, and reducing the craving for cocaine. Valproate is a GABAergic drug effective in the treatment of neuropathic pain and also in withdrawal from benzodiaepines, sedatives, and alcohol. The purpose of this double-blind trial was to evaluate the efficiency of valproate in reducing acute opiates withdrawal symptoms and duration of detoxification. Materials and methods: A total of 60 opium addicts, who met the DSM-IV criteria for opiate dependence were assigned randomly to treat with sodium valproate or placebo during a 26 day double-blind clinical trial. Both groups received methadone on an as-needed basis, tapered gradually, and clonidine . The severity of withdrawal symptoms were measured on days 2, 5, 9, 12, 19 and 26 using the modified short opioid withdrawal scale (SOWS).The results were compared between two groups with independent t-test. Findings: Valproate was not more effective than placebo in reducing physical symptoms of withdrawal syndrome or the duration of detoxification process. However, valproate was significantly effective in the management of mental symptoms. Conclusions: Sodium valproate may be an effective adjunctive therapy for management of the mental symptoms of opiates withdrawal. Larger studies are required to confirm these findings and to assess the efficacy of sodium valproate in the management of protracted abstinence syndrome and relapse prevention.