Ashrafian H, Bogle R G
Department of Cardiology, Ealing Hospital, London, UK.
Clin Nephrol. 2004 Jun;61(6):440-3. doi: 10.5414/cnp61440.
Lithium is still the treatment of choice in bipolar affective disorder. The patient presented here represents an example of the possible severity of metabolic defects resulting from lithium use. In this case, it caused severe intractable nephrogenic diabetes insipidus (NDI). Our case report draws attention to 2 important messages. The first is the complexity in treating psychiatric patients that is often not borne out in the medical literature. The second is the role and power of pharmacological augmentation. While the role of these agents has been appreciated for some time, the use of carbamazepine and of drug combinations is not as well recognized. We emphasize the clinical features of NDI, lithium's metabolic sequelae and furthermore collate the most up-to-date account of the signalling effects conferred by these agents in a summary diagram.
锂仍然是双相情感障碍的首选治疗药物。本文介绍的患者是锂使用导致代谢缺陷可能出现的严重程度的一个例子。在这个病例中，它导致了严重的顽固性肾性尿崩症（NDI）。我们的病例报告引出了两个重要信息。第一个是治疗精神科患者的复杂性，而这在医学文献中往往没有体现出来。第二个是药物增强治疗的作用和效果。虽然这些药物的作用已经被认识了一段时间，但卡马西平和药物联合使用的情况并没有得到同样的认可。我们强调了NDI的临床特征、锂的代谢后遗症，并进一步在一个总结图表中整理了这些药物所产生的信号传导效应的最新情况。
