苯妥英作为一种抗躁狂抗惊厥药物：一项对照研究。
Phenytoin as an antimanic anticonvulsant: a controlled study.
作者信息
Mishory A, Yaroslavsky Y, Bersudsky Y, Belmaker R H
机构信息
Stanley Center for Bipolar Research, Ministry of Health Mental Health Center, Ben Gurion University of the Negev, Beersheva, Israel.
出版信息
Am J Psychiatry. 2000 Mar;157(3):463-5. doi: 10.1176/appi.ajp.157.3.463.
OBJECTIVE
Phenytoin, a classical anticonvulsant, shares with antimanic anticonvulsants the property of blockade of voltage-activated sodium channels. The authors therefore planned a trial of phenytoin for mania.
METHOD
Patients with either bipolar I disorder, manic type, or schizoaffective disorder, manic type, entered a 5-week, double-blind controlled trial of haloperidol plus phenytoin versus haloperidol plus placebo. Of 39 patients, 30 completed at least 3 weeks and 25 completed 5 weeks.
RESULTS
Significantly more improvement was observed in the patients receiving phenytoin. Added improvement with phenytoin in scores on the Brief Psychiatric Rating Scale and Clinical Global Impression was seen in the patients with bipolar mania but not those with schizoaffective mania.
CONCLUSIONS
Blockade of voltage-activated sodium channels may be a common therapeutic mechanism of many anticonvulsants given for mania, and phenytoin may be a therapeutic option for some manic patients.
目的
苯妥英钠是一种经典的抗惊厥药，与抗躁狂抗惊厥药一样具有阻断电压激活钠通道的特性。因此，作者计划开展一项苯妥英钠治疗躁狂症的试验。
方法
患有I型双相情感障碍（躁狂型）或分裂情感性障碍（躁狂型）的患者进入一项为期5周的双盲对照试验，比较氟哌啶醇加苯妥英钠与氟哌啶醇加安慰剂的疗效。39名患者中，30名至少完成了3周的治疗，25名完成了5周的治疗。
结果
接受苯妥英钠治疗的患者有更显著的改善。在双相躁狂症患者中，苯妥英钠使简明精神病评定量表和临床总体印象量表的评分进一步改善，但在分裂情感性躁狂症患者中未观察到这种情况。
结论
阻断电压激活钠通道可能是许多用于治疗躁狂症的抗惊厥药的共同治疗机制，苯妥英钠可能是一些躁狂症患者的治疗选择。
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