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fighting per month * Mood liability as evidenced by multiple, daily, distinct shifts from normal to irritable mood with withdrawn or boisterous behavior, occurring without a clear precipitant * History of an EMD for one year without treatment * EMD symptoms resulting in impairment in two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