Marangell Lauren B, Martinez James M, Ketter Terence A, Bowden Charles L, Goldberg Joseph F, Calabrese Joseph R, Miyahara Sachiko, Miklowitz David J, Sachs Gary S, Thase Michael E
Mood Disorders Program, Department of Psychiatry, Baylor College of Medicine, Houston, TX 77030, USA.
Bipolar Disord. 2004 Apr;6(2):139-43. doi: 10.1111/j.1399-5618.2004.00098.x.
To describe the frequency and correlates of lamotrigine therapy among the first 500 patients enrolled into the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study.
Systematic recording of psychiatric history and medication data at intake into the STEP-BD project.
Of the participants with bipolar disorder type I or II (n = 483), 77 (15.4%) were currently taking lamotrigine (mean dose: 258.12 mg/day) and 52 (10.4%) reported prior lamotrigine use. The groups were comparable with regard to duration of illness and mood state at study entry. Compared with participants who had never taken lamotrigine, those currently treated with lamotrigine were significantly more likely to have a prior history of rapid cycling (62.5% vs. 43.1%; p < 0.01) and an antidepressant-induced switch to (hypo)mania (49.3% vs. 33.3%; p < 0.01). In contrast, only 16.9% of lamotrigine-treated participants were taking an antidepressant at study intake, as compared with 29.1% of participants with no history of lamotrigine therapy (p < 0.03).
While noting the limitations of a cross-sectional assessment, these data suggest that lamotrigine therapy was commonly used in these academic centers for patients with bipolar disorder several years before it was recommended in the American Psychiatric Association practice guidelines, particularly in patients with a history of rapid cycling or antidepressant-induced mania.
描述在双相情感障碍系统治疗强化项目（STEP - BD）研究中入组的前500例患者中拉莫三嗪治疗的频率及相关因素。
在STEP - BD项目入组时系统记录精神病史和用药数据。
在I型或II型双相情感障碍患者（n = 483）中，77例（15.4%）当前正在服用拉莫三嗪（平均剂量：258.12毫克/天），52例（10.4%）报告既往使用过拉莫三嗪。两组在疾病持续时间和研究入组时的情绪状态方面具有可比性。与从未服用过拉莫三嗪的参与者相比，当前接受拉莫三嗪治疗的参与者有快速循环既往史的可能性显著更高（62.5%对43.1%；p < 0.01），以及因抗抑郁药诱发转换为（轻）躁狂的可能性更高（49.3%对33.3%；p < 0.01）。相比之下，在研究入组时，接受拉莫三嗪治疗的参与者中只有16.9%正在服用抗抑郁药，而无拉莫三嗪治疗史的参与者这一比例为29.1%（p < 0.03）。
尽管注意到横断面评估的局限性，但这些数据表明，在美国精神病学协会实践指南推荐使用拉莫三嗪治疗双相情感障碍患者的数年之前，这些学术中心就已普遍使用该药物，尤其是在有快速循环病史或抗抑郁药诱发躁狂病史的患者中。
