Gross A, Devinsky O, Westbrook L E, Wharton A H, Alper K
Department of Neurology, New York University School of Medicine, New York, USA.
J Neuropsychiatry Clin Neurosci. 2000 Fall;12(4):458-64. doi: 10.1176/jnp.12.4.458.
Physicians are often reluctant to use psychotropic medications in epilepsy patients with psychiatric disorders because of concern over the potential risk for lowering seizure threshold. This study assesses retrospectively the impact of psychotropic medications on seizure frequency in 57 patients seen consecutively at an epilepsy center. During psychotropic drug therapy, seizure frequency decreased in 33% of patients, was unchanged in 44%, and increased in 23%. Mean seizure frequency was not statistically different between pre-treatment and treatment periods (t = 0.23, df = 56). Simultaneous adjustments in antiepileptic drug regimen could not account for the findings. Results support the position that psychotropic medications, introduced slowly in low to moderate doses, can be safely used in epilepsy patients with comorbid psychiatric pathology during the regular course of clinical care.
由于担心降低癫痫发作阈值的潜在风险，医生通常不愿在患有精神疾病的癫痫患者中使用精神药物。本研究回顾性评估了在一家癫痫中心连续就诊的57例患者中精神药物对癫痫发作频率的影响。在精神药物治疗期间，33%的患者癫痫发作频率降低，44%的患者癫痫发作频率不变，23%的患者癫痫发作频率增加。治疗前和治疗期间的平均癫痫发作频率在统计学上没有差异（t = 0.23，自由度 = 56）。抗癫痫药物治疗方案的同时调整不能解释这些结果。结果支持这样的观点，即在临床常规护理过程中，以低至中等剂量缓慢引入的精神药物可以安全地用于患有合并精神病理的癫痫患者。
