Psychiatric symptoms after therapy with new antiepileptic drugs:: Psychopathological and seizure related variables
Psychiatric symptoms after therapy with new antiepileptic drugs:: Psychopathological and seizure related variables
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DOI：
10.1053/seiz.2000.0405
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发表时间：
2000-06-01
影响因子：
3
通讯作者：
Crawford, PM
中科院分区：
文献类型：
--
作者：
Trimble, MR;Rüsch, N;Crawford, PM
本文旨在了解抗癫痫药物（AEDs）、患者特征、癫痫发作模式变化与突发精神障碍（即精神病或情感障碍）之间的关系。为此，我们对89例在接受托吡酯、氨己烯酸或噻加宾治疗期间出现精神症状的患者进行了回顾性病例研究。精神问题是情感性或精神病性障碍（不包括情感性精神病）。结果发现，99%的患者患有复杂部分性癫痫发作伴或不伴继发全身性发作。超过一半的人正在接受两种或两种以上其他AED的综合治疗。近三分之二的人以前有精神病史。既往精神疾病类型与新出现的精神问题类型之间存在很强的相关性，无论是精神病还是情感障碍。与托吡酯组相比，氨己烯酸组患者癫痫发作更早，神经系统异常更多。使用较低剂量的患者在AED治疗开始和精神问题发作之间的间隔较短。超过一半的患者在出现精神症状之前都有一段无精神病期，其中更多的人可能会发展为精神病而不是情感障碍。右侧癫痫发作的抑制似乎与精神问题的发生有关。得出的结论是，有精神病或情感障碍病史的患者倾向于在使用新的AED时出现相同的精神问题。那些在精神问题出现之前有一段时间没有精神病的人更有可能发展成精神病而不是情感障碍。(C)2000年，中国国际贸易有限公司
The purpose of this paper is to understand the association between antiepileptic drugs (AEDs), patient characteristics, changes in seizure pattern and emergent psychiatric disorder, i.e. psychosis or affective disorder. To this end we carried out a retrospective casenote study on 89 patients who developed psychiatric symptoms during treatment with topiramate, vigabatrin or tiagabine. The psychiatric problem was either an affective or a psychotic disorder (not including affective psychoses). It was discovered that 99% of the patients suffered from complex partial seizures with or without secondary generalization. More than half were on polytherapy with two or more other AEDs. Nearly two-thirds had a previous psychiatric history. There was a strong association between the type of previous psychiatric illness and the type of emerging psychiatric problem, both for psychoses and for affective disorders. Patients on vigabatrin had an earlier onset of epilepsy and more neurological abnormalities than those on topiramate. Those patients on lower doses had a shorter interval between the start of the AED therapy and the onset of the psychiatric problem. A seizure-free period was observed in more than half of the patients before they developed the psychiatric symptoms, and of these more were likely to develop a psychosis rather than an affective disorder. There seemed to be an association of suppression of right-sided seizures and the onset of the psychiatric problem. The conclusions drawn were that patients with a previous history of psychosis or affective disorder tended to develop the same psychiatric problem with new AEDs. Those with a seizure-free period before the onset of the psychiatric problem were more likely to develop a psychosis than an affective disorder. (C) 2000 BEA Trading Ltd.