Effectiveness of Divalproex Sodium (Depakote) in Treating Children With Temper Outbursts and Severe Mood Swings

Inclusion Criteria: Meets criteria for Explosive Mood Disorder (EMD) Explosive temper as evidenced by four or more outbursts of rage, property destruction, or fighting per month Mood liability as evidenced by multiple, daily, distinct shifts from normal to irritable mood with withdrawn or boisterous behavior, occurring without a clear precipitant History of an EMD for one year without treatment EMD symptoms resulting in impairment in two or more of the following areas: school, the law, family, substance use, peers, or work EMD symptoms do not occur only during substance toxicity or withdrawal EMD symptoms are not confined to a single setting or context Parent and child willing to consent to study Inadequate response to an adequate trial (8 weeks) of psychotherapy and/or family therapy Exclusion Criteria: Meets criteria for pervasive developmental disorder or childhood schizophrenia Seizure or other neurologic disturbance Pregnant Moderate to severe mental retardation Physical exam or laboratory results with significant abnormalities Positive Hepatitis screen test Liver dysfunction Active suicidal or homicidal ideation History of suicide attempts History of barbiturate use Unequivocal manic or hypomanic episode Meets criteria for attention deficit hyperactivity disorder (ADHD) and has not failed a trial of psychostimulants for ADHD Meets criteria for major depression in prepuberty If female, unwilling to use an effective method of contraception for the duration of the study Mitochondrial disease or family history of mitochondrial disease