Treatment of bipolar disorder
Treatment of bipolar disorder
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DOI：
10.5694/j.1326-5377.1992.tb126404.x
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发表时间：
1992-01
影响因子：
11.4
通讯作者：
Philip B. Mitchell;Gordon Parker
中科院分区：
文献类型：
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作者：
Philip B. Mitchell;Gordon Parker
目的回顾双相情感障碍（躁狂抑郁症）的治疗现状。数据来源和研究选择检查了对照临床试验以及最近一些重要的开放研究。数据提取和合成碳酸锂仍然是这种情况的急性和预防性治疗的支柱。我们强调了锂预防性治疗中的具体争议问题，即开始长期治疗的适应症、首选血清浓度、给药时间、治疗持续时间和实验室监测频率。近年来，已证明锂的几种替代品在不能耐受或对该药物反应不充分的患者的急性和预防性治疗中均有效。现在有大量证据表明，卡马西平与锂盐具有相似的疗效，最近的研究表明，丙戊酸盐也可能具有治疗作用。我们概述了每种药物的临床作用的细节，以及有关监测和不良反应的指南。
OBJECTIVE To review the current status of the management of bipolar disorder (manic-depressive illness). DATA SOURCES AND STUDY SELECTION Controlled clinical trials as well as some recent important open studies are examined. DATA EXTRACTION AND SYNTHESIS Lithium carbonate remains the mainstay of both the acute and prophylactic treatment of this condition. We highlight specific contentious issues in prophylactic management with lithium, that is, indications for initiating long-term treatment, preferred serum concentrations, timing of the dose, duration of treatment and frequency of laboratory monitoring. In recent years, several alternatives to lithium have been demonstrated as effective in both the acute and prophylactic treatment of patients either unable to tolerate or inadequately responsive to this agent. There is now considerable evidence that carbamazepine is of similar efficacy to lithium and more recent studies suggest that valproate may also be as therapeutic. We outline details of the clinical roles of each of these agents, with guidelines concerning monitoring and adverse effects.