Ramasubbu Rajamannar
Department of Psychiatry, University of Calgary, Foothills Medical Centre, Room AW258A, 1403-29th Street NW, Calgary, Alberta, Canada T2N 2T9.
Clin Neuropharmacol. 2003 Sep-Oct;26(5):233-5. doi: 10.1097/00002826-200309000-00006.
Pathologic laughing and crying (PLC) is a common distressing and socially disabling condition in stroke patients. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), have been increasingly recognized as the treatment of choice for pathologic crying (PC). However, little is known about etiologies and other treatment options for various clinical manifestations of PLC. This case report illustrates the beneficial effect of lamotrigine, a novel antiepileptic drug with antidepressant and mood-stabilizing properties in post-stroke PLC. A 60-year-old woman developed PLC after an ischemic stroke affecting the left frontal and temporal lobes. She was treated with lamotrigine initially at the dose of 50 mg a day, which was gradually increased to 100 mg a day over a 4-week period. There was a significant and rapid recovery in both laughing and crying components of PCL with lamotrigine treatment. The symptoms of pathologic laughing have shown a better response to lamotrigine than PC. Controlled investigations are needed to evaluate the beneficial as well as the differential effects of lamotrigine on PLC.
病理性哭笑（PLC）是中风患者常见的令人痛苦且导致社交障碍的病症。抗抑郁药，尤其是选择性5-羟色胺再摄取抑制剂（SSRI），已越来越多地被视为病理性哭泣（PC）的首选治疗方法。然而，对于PLC各种临床表现的病因及其他治疗选择知之甚少。本病例报告阐述了拉莫三嗪（一种具有抗抑郁和情绪稳定特性的新型抗癫痫药物）对中风后PLC的有益作用。一名60岁女性在发生影响左额叶和颞叶的缺血性中风后出现了PLC。她最初接受拉莫三嗪治疗，剂量为每日50毫克，并在4周内逐渐增至每日100毫克。拉莫三嗪治疗后，PCL的哭笑症状均有显著且迅速的改善。病理性笑的症状对拉莫三嗪的反应比对PC更好。需要进行对照研究以评估拉莫三嗪对PLC的有益作用及差异作用。
