Schaffer L C, Schaffer C B, Caretto J
Sutter Community Hospitals, Sacramento, California, USA.
Ann Clin Psychiatry. 1999 Jun;11(2):61-6. doi: 10.1023/a:1022338330606.
Four anticonvulsant medications (carbamazepine, valproate, gabapentin and lamotrigine) have received attention in the psychiatric literature as efficacious treatment for bipolar disorder, either as monotherapy or as adjunctive agents. Although two earlier reports in 1993 suggested that primidone may also be helpful for bipolar disorder, this older anticonvulsant has not been evaluated in any subsequent studies to confirm these earlier findings. In the present prospective open study, 26 patients with refractory bipolar disorder were treated with primidone as an adjunctive therapy. Eight (31%) patients experienced a persistent positive therapeutic effect. Five (19%) patients were considered partial or temporary responders to primidone. The remaining 13 patients (50%) were considered treatment failures. Although a 31% response rate is considered modest in most psychotropic medication studies, the authors believe that this success rate is significant in this refractory patient population and should provide impetus for future more scientific studies to confirm the preliminary findings of this open trial.
四种抗惊厥药物（卡马西平、丙戊酸盐、加巴喷丁和拉莫三嗪）在精神病学文献中受到关注，被视为治疗双相情感障碍的有效药物，可作为单一疗法或辅助药物。尽管1993年的两份早期报告表明扑米酮可能对双相情感障碍也有帮助，但这种较老的抗惊厥药物在随后的任何研究中都未得到评估以证实这些早期发现。在本前瞻性开放研究中，26例难治性双相情感障碍患者接受了扑米酮辅助治疗。8例（31%）患者经历了持续的积极治疗效果。5例（19%）患者被认为对扑米酮有部分或暂时反应。其余13例患者（50%）被认为治疗失败。尽管在大多数精神药物研究中31%的有效率被认为不高，但作者认为这一成功率在这群难治性患者中具有重要意义，应为未来更科学的研究提供动力，以证实这项开放试验的初步发现。
