摘要
雙極性障礙症是一種易復發、且嚴重的精神疾病，若無適當治療，有高比率的發病率及死亡率，治療的主要原則是急性症狀控制、防止復發、及減少殘餘症狀。藥物治療是最基本的療法，分成3個治療時期：1)急性躁症發作與混合發作，單一種藥物治療如鋰鹽、valproate、carbamazepine、chlorpromazine、olanzapine、risperidone、quetiapine、ziprasidone、及aripiprzole，或情緒穩定劑+抗精神病藥物，對急性躁症有顯著療效。2)急性雙極性憂鬱症發作，較常用的方法是情緒穩定劑＋抗鬱劑，而lamotrigine、非典型抗精神病藥物、或非典型抗精神病藥物＋抗鬱劑是治療的新方法。3)維持治療，鋰鹽、valproate、與carbamazepine預防躁症發作效果較佳，而lamotrigine預防雙極性憂鬱症發作較佳，大部分病人需要併用多種藥物治療。除了藥物治療外，電痙攣治療也是有效的療法。醫師應同時配合心理治療的技巧，達到最佳療效。
並列摘要
Bipolar disorder is a recurrent and severe psychiatric illness that is associated with high rates of morbidity and mortality when inadequate treatment. To control the acute episodes, prevent the relapse, and decrease the residual symptoms are the goods. Medication is the main treatment for bipolar disorder and divided into three stages, 1) Acute manic and mixed episodes: Monotherapy with lithium, valproate, carbamazepine, chlorpromazine, olanzapine, risperidone, quetiapine, ziprasidone, and aripiprzole or a mood stabilizers with anipsychotics also have significant efficacy in acute mania; 2) Acute bipolar depressive episodes: Mood stabilizers with antidepressants is a common approach. Lamotrigine, atypical antipsychotics, or atypical antipsychotics with antidepressants are the new strategies to treat bipolar depression; 3) Maintenance: Lithium, valproate, and carbamazepine appear to have greater efficacy in the prevention of manic than depressive episodes. In contrast, lamotrigine appears to have greater efficacy in the prevention of depressive than manic episodes. Combination therapy is often necessary in clinical practice. Electroconvulsive therapy (ECT) is an alternative to drugs in treating bipolar disorder. Psychotherapy, providing support, education and guidance to patients and their families, combines with medication will get the optimal effectiveness in bipolar disorder treatment.
延伸閱讀
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