Combination Therapy in Dual Diagnosis Rapid Cycling BPD in Both the Tertiary Care

来自MH-50165及其补充材料的初步数据表明，Li/Dvpx的组合导致 快速循环BPD有显著的抗躁狂效果，但抗抑郁效果不明显。大多数人没有回复 可归因于耐药抑郁症(73%和62%的耐药抑郁症和27%和38%的耐药抑郁症 轻躁狂/躁狂症/混合症)。我们认为这些数据表明更广泛有效的养生法是 需要，例如，添加具有更有效的抗抑郁特性的第三种试剂。为了满足这一需求，R21 MH-62650支持修改的随机分配、单中心、6个月、双盲、平衡并行组 两种联合治疗方案(锂/异丙丙胺/拉莫三嗪盲用与对照)的比较 锂/异丙丙胺/安慰剂)，用于抑郁症、轻躁狂症和 90名患者出现躁狂症，表现为抑郁症的指标性发作。项目3提议开展类似的 设计的研究，但适用于目前同时患有酒精、可卡因和/或大麻的患者 滥用依赖。到目前为止，还没有公开发表的关于患有BPD的成年人的随机对照试验。 目前正在酗酒或吸毒。

Preliminary data from MH-50165 and its Supplement suggest that combination Li/Dvpx results in marked antimanic effectiveness in rapid-cycling BPD, but modest antidepressant effects. Most of the non-response was attributable to treatment-resistant depression (73% and 62% resistant depression and 27% and 38% resistant hypomania/mania/mixed, respectively). We believe these data suggest that more broadly effective regimens are needed, e.g., the addition of a third agent with more potent antidepressant properties. To address this need, R21 MH-62650 is supporting a modified random assignment, single-center, 6-month, double blind, balanced parallelgroup comparison of two regimens of combination therapy (lithium/divalproex/blinded lamotrigine versus lithium/divalproex/placebo) for the acute and continuation outpatient management of depression, hypomania, and mania in 90 patients presenting in an index episode of depression. Project #3 proposes to carry out a similarly designed study, but in patients who are currently comorbid with alcohol, cocaine, and/or cannabis abuse dependence. To date, there are no published randomized, controlled trials in adults with BPD who are currently abusing alcohol or drugs.