对长期锂盐预防性治疗反应良好的双相情感障碍患者的锂盐停药对照研究。
Controlled lithium discontinuation in bipolar patients with good response to long-term lithium prophylaxis.
作者信息
Yazici Olcay, Kora Kaan, Polat Aslihan, Saylan Mete
机构信息
Department of Psychiatry, Istanbul Faculty of Medicine, University of Istanbul, Istanbul 80200, Turkey.
出版信息
J Affect Disord. 2004 Jun;80(2-3):269-71. doi: 10.1016/S0165-0327(03)00133-2.
BACKGROUND
This study aims to investigate whether the risk of recurrence following lithium discontinuation is less than reported in discontinuation of a successful, long-term prophylaxis in bipolar patients.
METHODS
A total of 32 bipolar patients discontinued lithium according to the controlled lithium discontinuation (CLD) protocol following a definite good response to lithium maintenance of at least 5 years. Subjects were followed for up to 9 years.
RESULTS
The total rate of recurrence was 7% in the first week, 32% in the first month, 62% in the first year, and 81% at the end of the 9th year following discontinuation. Only six of the 32 patients (19%) did not have a recurrence during the follow-up period.
CONCLUSIONS
Discontinuation of lithium seems to be followed by a high rate of recurrence in bipolar patients even after good response to a long-duration illness-free period. A controlled discontinuation protocol can reduce the risks of morbidity.
背景
本研究旨在调查双相情感障碍患者停用锂盐后复发风险是否低于成功进行长期预防治疗后停药的报告风险。
方法
共有32例双相情感障碍患者在对锂盐维持治疗至少5年有明确良好反应后，根据锂盐控制停药（CLD）方案停用锂盐。对受试者随访长达9年。
结果
停药后第1周复发率为7%，第1个月为32%，第1年为62%，第9年末为81%。32例患者中只有6例（19%）在随访期间未复发。
结论
即使在长期无病期有良好反应后，双相情感障碍患者停用锂盐后似乎仍有较高的复发率。控制停药方案可降低发病风险。
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