鋰塩合併癲通治療情感性精神病之臨床研究

A Clinical Study on Combined Lithium and Carbamazepine Treatment of Major Affective Disorders

陳正宗(Cheng-Chung Chen) ； 柯偉恭(Wei-Kung Ko)

《The Kaohsiung Journal of Medical Sciences》 3卷3期 (1987/03) Pp. 176-181

https://doi.org/10.6452/KJMS.198703.0176

摘要

A number of potential alternatives to lithium therapy have emerged, some on the basis of empirical clinical experimentation and others as products of intriguing, but as yet unproven theories as to the pathogenesis of affective disorders and the mechanism of lithium's control on these major affective disorders. The authors reviewed the records of 15 patients (11 males and 4 females, mean age: 30.7±10.3 years) who had been hospitalized at least twice because of affective symptoms (bipolar disorder: 14, schizoaffective disorder: 1). All the patients were treated with a combination of lithium and neuroleptics (group I) during the first hospitalization, and were later treated with a combination of lithium, carbamazepine and neuroleptics (group Ⅱ) during the following hospitalization due to relapse. Comparison between the two groups showed no significant difference in daily lithium dosage, serum level of lithium, daily neuroleptic dosage (transformed to be as equivalent to chlorpromazine), total hospitalization, or electroconvulsive therapy. The relapse of 5 cases (33%) in group II was also less than in group Ⅰ (9 cases, 60%) during the period of 12.7±12.2 months (Mean±SD) (X^2=7.1428, df=1, p＜0.05). The relapse factors implied to be associated with relapse in group Ⅰ were discontinuance of lithium (N=4), cessation of neuroleptics (N=1) and lithium nonrespondence (N=4). The implied relapse factors in group Ⅱ were discontinuance of carbamazepine (N=2), and cessation of lithium and carbamazepine (N=3). The effectiveness of carbamazepine in the prophylaxis of major affective disorders is discussed.

並列摘要

A number of potential alternatives to lithium therapy have emerged, some on the basis of empirical clinical experimentation and others as products of intriguing, but as yet unproven theories as to the pathogenesis of affective disorders and the mechanism of lithium's control on these major affective disorders. The authors reviewed the records of 15 patients (11 males and 4 females, mean age: 30.7±10.3 years) who had been hospitalized at least twice because of affective symptoms (bipolar disorder: 14, schizoaffective disorder: 1). All the patients were treated with a combination of lithium and neuroleptics (group I) during the first hospitalization, and were later treated with a combination of lithium, carbamazepine and neuroleptics (group Ⅱ) during the following hospitalization due to relapse. Comparison between the two groups showed no significant difference in daily lithium dosage, serum level of lithium, daily neuroleptic dosage (transformed to be as equivalent to chlorpromazine), total hospitalization, or electroconvulsive therapy. The relapse of 5 cases (33%) in group II was also less than in group Ⅰ (9 cases, 60%) during the period of 12.7±12.2 months (Mean±SD) (X^2=7.1428, df=1, p＜0.05). The relapse factors implied to be associated with relapse in group Ⅰ were discontinuance of lithium (N=4), cessation of neuroleptics (N=1) and lithium nonrespondence (N=4). The implied relapse factors in group Ⅱ were discontinuance of carbamazepine (N=2), and cessation of lithium and carbamazepine (N=3). The effectiveness of carbamazepine in the prophylaxis of major affective disorders is discussed.

並列關鍵字

major affective disorders ； combined lithium and carbamazepine