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Valproate may be as effective and a safer treatment for the behavioral complications of dementia, particularly of the Alzheimer's type. It is most helpful with symptoms of physical aggression. Valproate appears to be better tolerated due to a more benign side effect profile and fewer drug-drug interactions. It may reduce behavioral agitation without sedation or other cognitive or neurological side effects (Lott et al., 1995; McElroy et al., 1996). Gastrointestinal distress, such as nausea, dyspepsia and diarrhea, and weight gain are possible but infrequent. These effects can be further minimized by the use of divalproex sodium, a delayed-release tablet. Published studies show no significant laboratory abnormalities. The rare occurrence of hepatic transaminase elevations and thrombocytopenia are both reversible (American Psychiatric Association, 1997; McElroy et al., 1996; Sanborn et al., 1995).

It is often difficult to distinguish between weight gain from a drug and weight gain from other reasons, like diet or lack of exercise, because it can be a slow process. Some conditions, like depression, can lead to weight loss or, more rarely, weight gain, depending upon the person. Weight gain may increase the chance for high cholesterol , hypertension (high blood pressure), and type 2 diabetes. If a rapid weight gain occurs in a short period of time, a physician should be contacted for evaluation, especially if you are at risk for heart disease or high blood pressure.

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