LITHIUM LEVELS AND NEUROLEPTICS IN BIPOLAR ILLNESS

这项研究将解决两个重要的和悬而未决的问题， 双相情感性疾病患者的维持治疗。 一 关于有效的最低血清锂浓度， 预防或减轻未来的情感复发。 我们计划 比较和对比两种不同的血清锂水平（0.4至0.6， 0.8至1.0mEq/升）关于其防止复发的能力， 不太严重的情感症状的存在，以及它们与 有害和有毒影响-如肾和甲状腺损害 功能和不舒服的“副作用”（例如，震颤，体重增加， 认知障碍）。 本建议的第二部分侧重于 复发风险特别高的一组，对比两种维持疗法， 尽管服用锂剂但躁狂复发的患者的治疗方案 维持治疗;单独持续锂治疗与锂加治疗 癸酸氟奋乃静 两项研究均为双盲研究， 马萨诸塞州总医院和长岛 犹太山坡医疗中心 第一批将涉及175名受试者， 两个研究中心的第二个50名受试者， 五年

This study will address two important and unresolved issues regarding the maintenance therapy of patients with bipolar affective illness. One concerns the minimum serum lithium concentration effective for the prevention or attenuation of future affective recurrences. We plan to compare and contrast two different levels of serum lithium (0.4 to 0.6 and 0.8 to l.0 mEq/liter) regarding their ability to protect against relapse, the presence of less severe affective symptoms, and their association with unwanted and toxic effects--such as impairment of renal and thyroid function and uncomfortable "side effects" (e.g., tremor, weight gain, and cognitive impairment). The second component of this proposal focuses on a group at particularly high risk for relapse, contrasting two maintenance regimens for patients who experience manic relapses despite lithium maintenance; continued lithium therapy alone versus lithium plus fluphenazine decanoate. Both studies will be double-blind and will involve a collaboration between the Massachusetts General Hospital and Long Island Jewish-Hillside Medical Center. The first will involve l75 subjects at the two sites over five years, the second 50 subjects at the two sites over five years.