Macdonald Kathryn J, Young L Trevor
Mood Disorder Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
CNS Drugs. 2002;16(8):549-62. doi: 10.2165/00023210-200216080-00004.
Antiepileptic drugs (AEDS) are used regularly in the treatment of patients with bipolar disorders. Carbamazepine and valproic acid (sodium valproate) are effective as antimanic treatments, and the success of these medications has prompted investigation of other AEDs as possible treatments in patients with mood disorders. Lamotrigine appears to be the most promising of the newer AEDs with respect to effects in mood disorders. Current evidence suggests efficacy of this drug both as monotherapy and as an adjunctive agent in bipolar depression, and studies are underway to clarify its efficacy in mood stabilisation and rapid cycling, as currently available data are equivocal. Use of gabapentin is not as well supported in the literature, although data from open trials using it as an adjunctive agent suggest that it may be helpful in patients with bipolar depression. There have been some open trials and case reports supporting the use of topiramate as an adjunctive agent for the treatment of mania; however, data from controlled trials are not yet available. Further controlled trials of lamotrigine, gabapentin or topiramate as monotherapy and adjunctive treatment are needed to clarify their potential roles in the treatment of patients with mood disorders.
抗癫痫药物（AEDS）常用于治疗双相情感障碍患者。卡马西平和丙戊酸（丙戊酸钠）作为抗躁狂治疗有效，这些药物的成功促使人们研究其他抗癫痫药物作为情绪障碍患者可能的治疗方法。就对情绪障碍的影响而言，拉莫三嗪似乎是较新的抗癫痫药物中最有前景的。目前的证据表明，这种药物作为单一疗法和双相抑郁的辅助药物均有效，并且由于目前可得的数据不明确，正在进行研究以阐明其在情绪稳定和快速循环方面的疗效。加巴喷丁在文献中的支持较少，尽管将其作为辅助药物的开放试验数据表明它可能对双相抑郁患者有帮助。有一些开放试验和病例报告支持托吡酯作为治疗躁狂的辅助药物；然而，尚无对照试验的数据。需要进一步对拉莫三嗪、加巴喷或托吡酯作为单一疗法和辅助治疗进行对照试验，以阐明它们在情绪障碍患者治疗中的潜在作用。
