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Valproate is the most common drug to use in bipolar disorder in Indonesia and the only mood stabilizer drug in national formulary. Combination of valproate and fluoxetine are the most used combination in bipolar disorder therapy in Bhayangkara Hospital, Kediri. However, this combination has been controversial because of its risk of triggering mania or hipomania episode in 12 months. The aim of this study was to analyze mood change symptoms with YMRS and MADRS scale after treatment of valproate and fluoxetine combination in continuation phase treatment of bipolar disorder. This cross-sectional, observational study was conducted in psyciatry clinic in Bhayangkara Hospital Kediri between August 2016-October 2016 on 15 patients in YMRS. MADRS questionnaire was filled by physician before treatment and after 8 weeks treatments. Within 8 weeks, mean YMRS score changed from 1.4 to 1.26 (p>0.05). Whereas, mean MADRS score changed from 31.8 to 10.93 (p<0.05) after 8 weeks. There was no significant different in YMRS score between pre- and post-treatment, but there was significant different in MADRS score after treatment.


Bipolar disorder valproate fluoxetine YMRS MADRS

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Trengginas, G. T., Hasmono, D., & Subagyo, R. (2018). Effects of Valproate and Fluoxetine Combination on YMRS and MADRS Sores in Continuation Phase Treatment of Bipolar Disorder. Folia Medica Indonesiana, 54(4), 234–240.


  1. Brunton LL, Chabner BA, dan Knollmann BC, 2010. Goodman and Gilman's The Pharmacological Basis of Therapeutics 12th Edition. pp-397-414
  2. Corryell W, 2013. Bipolar Disorders. Merck Manual Professional. Diakses dari: disorders/bipolar-disorders
  3. DeBattista C, Eisendrath SJ, dan Lichtmacher JE, 2015. Mood Disorder. Psychiatric Disorders. In: CURRENT Medical Diagnosis and Treatment 44th Edition. McGraw-Hill. pp-1051-1053
  4. Gajwani P, 2009. Treatment-refractory bipolar disorder: classification to aid in clinical management. Expert Opinion on Pharmacotherapy. 10:12, 1907-1915
  5. Ghaleiha A, Haghighi M, Sharifmehr M, et al, 2014. Oral Loading of Sodium Valproate Compared to Intravenous Loading and Oral Maintenance in Acutely Manic Bipolar Patients. Neuropsychobiology 70:29-35
  6. Gijsman HJ, Geddes JR, Rendell JM et al, 2004. Antidepressants for Bipolar Depression: A Systematic Review of Randomized, Controlled Trials. Am J Psychiatry. 161:1537-1547
  7. Grunze H, Vieta E, Goodwin GM, et al (2018). The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2012 on the long-term treatment of bipolar disorder. The World Journal of Biological Psychiatry. 14: 154-219
  8. Lacy, C.F., Amstrong, L.L., Goldman, N.P., et al, 2009. Drug Information Handbook 18th edition. APhA : Lexi-Comp.
  9. Lukasiewicz M, Gerard S, Besnard A, et al, 2013. Young Mania Rating Scale: how to interpret the numbers? Determinationof a severity threshold and of the minimal clinically significant difference in the EMBLEM cohort. Int. J. Methods Psychiatr. Res. 22(1): 46-58
  10. Moosavi SM, Ahmadi M, dan Monajemi MB, 2014. Risperidone Versus Risperidone PlusSodium Valproate for Treatment of Bipolar Disorders: A Randomized, Double-Blind Clinical-Trial. Global Journal of Health Science; Vol. 6, No. 6
  11. Peselow ED, Naghdechi L, Pizano D, IsHak WW, 2016. Polypharmacy in Maintenance of Bipolar Disorder. Clinical Neuropharmacology. 39(3): 132-134
  12. Pytliak M, Vargova V, Mechirova V, et al, 2011. Serotonin Receptors-From Molecular Biology to Clinical Applications. Physiol. Res. 60: 15-25
  13. Raza MU, Tufan T, Wang Y, Hill C, dan Zhu MY, 2016. DNA Damage in Major Psychiatric Diseases. Neurotox Res. 30: 251-257
  14. Reus VI, 2015. Mental Disorder. In: Harrison's Principles of Internal Medicine 19th Edition.McGraw-Hill. pp-2717-2719
  15. Truman CJ, Goldberg JF, Ghaemi SN et al, 2007. Self-reported history of manic/hypomanic switch associated with antidepressant use: data from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). J Clin Psychiatry. 68(10):1472-9
  16. WHO, 2001. Global Burden of Disease 2000 Study. World Health Report
  17. Widmaier EP, Raff H, dan Strang KT, 2014. Vander's Human Physiology: Mechanism of Body Function. 13th Edition. pp-167-172

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