Antidepressant-associated mania: a controlled comparison with spontaneous mania.
Antidepressant-associated mania: a controlled comparison with spontaneous mania.
复制标题
抗抑郁药相关的躁狂症：与自发躁狂症的对照比较。
DOI：
10.1176/ajp.151.11.1642
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
Tohen,M
中科院分区：
文献类型：
--
作者：
Stoll,AL;Mayer,PV;Kolbrener,M;Goldstein,E;Suplit,B;Lucier,J;Cohen,BM;Tohen,M
目的抗抑郁药与躁狂的诱导和快速循环有关。这项研究调查了抗抑郁药相关的躁狂状态是否与自发性躁狂有任何不同。方法对49例连续住院的抗抑郁药相关躁狂患者与49例匹配的自发性躁狂患者进行盲法回顾性分析。结果在几乎所有的临床测量中，抗抑郁药相关的躁狂状态患者比自发性躁狂患者经历了更轻的、更有时间限制的躁狂发作。抗抑郁药相关性躁狂患者接受护士频繁检查和大厅限制的时间明显短于自发性躁狂患者。根据一项标准评定工具，与自发性躁狂患者相比，患有抗抑郁药相关躁狂状态的患者在妄想、幻觉、精神运动性躁动和怪异行为方面的严重程度也明显较轻。为了进一步研究，将抗抑郁相关躁狂症患者分为亚组，分别服用4类抗抑郁药物：三环类药物（N= 19）、氟西汀（N= 13）、单胺氧化酶抑制剂（N= 8）和安非他酮（N= 6）；三名服用联合用药的患者未包括在这些分析中。maoi和安非他酮相关躁狂症患者入院时的精神病理严重程度总体评分略低于氟西汀和三环相关躁狂症亚组。结论抗抑郁药相关性躁狂是一种比自发性躁狂更温和、更有时间限制的综合征，可能是一种独特的临床实体。与三环类药物或氟西汀相比，MAOIs和安非他酮可能与轻度躁狂状态有关。
ObjectiveAntidepressants have been associated with the induction of mania and rapid cycling. This study examined whether antidepressant-associated manic states differ in any way from spontaneous mania.MethodForty-nine consecutive inpatients with antidepressant-associated manic states were compared with 49 matched inpatients with spontaneous mania in a blind, retrospective chart review.ResultsAcross virtually every clinical measure examined, the patients with antidepressant-associated manic states experienced milder and more time-limited manic episodes than the patients with spontaneous mania. The patients with antidepressant-associated manic states were subject to frequent checking by nurses and hall restriction for a significantly shorter period of time than the patients with spontaneous mania. The patients with antidepressant-associated manic states also had significantly less severe levels of delusions, hallucinations, psychomotor agitation, and bizarre behavior, according to a standard rating instrument, than the patients with spontaneous mania. For further study the patients with antidepressant-associated mania were divided into subgroups taking four individual classes of antidepressant drugs: tricyclics (N= 19), fluoxetine (N= 13), monoamine oxidase inhibitors (MAOIs)(N= 8), and bupropion (N= 6); three patients taking combinations of drugs were not included in these analyses. The patients with MAOI-and bupropion-associated mania had a slightly lower overall rating of severity of psychopathology at admission than the subgroups with fluoxetine-and tricyclic-associated mania.ConclusionsAntidepressant-associated mania appears to be a milder and more time-limited syndrome than spontaneous mania and may represent a distinct clinical entity. MAOIs and bupropion may be associated with milder manic states than either tricyclic drugs or fluoxetine.