CIRCADIAN INTERVENTIONS IN PATIENTS WITH RAPID-CYCLING BIPOLAR DISORDER

对快速循环性双相情感障碍患者的昼夜节律干预

• 批准号: 6111188
• 负责人: Ellen Leibenluft
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6111188
• 关键词: bipolar depression; circadian rhythms; clinical research; clinical trials; combination therapy; human subject; human therapy evaluation; melatonin; mental disorder chemotherapy; phototherapy; sleep disorders; visible light

Patients with rapid cycling bipolar disorder (RCBD) experience at least four episodes of mania, hypomania, and/or depression in a year. They suffer significant morbidity and are frequently resistant to conventional treatments. An unstable sleep/wake cycle is both characteristic of the illness and feeds back on the symptoms so as to exacerbate them. In this series of projects, we are exploring whether interventions designed to stabilize the sleep-wake and circadian systems have mood-stabilizing effects in patients with RCBD. In patients with RCBD, we have explored systematically the effects on mood of daily treatment with bright light, extended scotoperiod (dark), or exogenous melatonin, as well as the effects on mood of acute bright or dim light. We found that chronic treatment with midday bright light or extended scotoperiod may have mood-stabilizing effects; the former is being studied further in a controlled clinical trial. Neither acute bright or dim light, daily evening light, nor daily exogenous melatonin had a significant effect on mood in patients with RCBD. Melatonin was prescribed in doses of 5.0 or 10.0 mg each day, administered at 8:00 or 10:00 p.m. There was preliminary evidence that morning phototherapy might destabilize mood in patients with RCBD.

快速循环型双相情感障碍（RCBD）患者至少经历 一年内有四次躁狂、轻躁狂和/或抑郁发作。 他们 并经常对常规抗结核药物有抵抗力 治疗。 不稳定的睡眠/觉醒周期是两个特征， 疾病，并对症状进行反馈，以加剧症状。 在这 一系列的项目，我们正在探索是否干预设计， 稳定睡眠-觉醒和昼夜节律系统具有稳定情绪 对RCBD患者的影响 在RCBD患者中，我们探索了 系统地研究了每天用强光治疗对情绪的影响， 延长的暗期（黑暗），或外源性褪黑激素，以及 对情绪的影响急性明亮或昏暗的光线。 我们发现慢性 中午明亮的光线或延长的暗期治疗可能有 情绪稳定的影响;前者正在进一步研究中， 对照临床试验。 既不急亮也不急暗，每天 晚上光照，也不是每天外源性褪黑素有显着影响， RCBD患者的情绪。 褪黑激素的处方剂量为5.0或 10.0 mg/天，在晚上8：00或10：00给药。 初步证据表明，早晨光疗可能会使情绪不稳定， RCBD患者