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[碳酸锂、卡马西平和丙戊酸钠预防性用于情感性精神病和分裂情感性精神病的比较疗效]

[Comparative effectiveness of preventive use of lithium carbonate, carbamazepine and sodium valproate in affective and schizoaffective psychoses].

作者信息

Mosolov S N

出版信息

Zh Nevropatol Psikhiatr Im S S Korsakova. 1991;91(4):78-83.

PMID:1650105
Abstract

To specify differentiated indications for preventive use of normothymic drugs, a prospective study was made of 3 groups of patients with phasic endogenous psychoses, comparable as regards the main ++clinico-anamnestic characteristics. The patients had been administered lithium carbonate (LC, 30 persons), carbamazepine (CRB, 30 patients), and sodium valproate (SV, 28 patients) for no less than one year. It was discovered that all the drugs exhibited marked preventive action to an equal degree. The mean annual magnitude of the total duration of the affective symptomatology reduced by 49.3% in LC administration, by 55.9% in CRB, and by 45.6% in SV administration; the rate of episodes decreased by 53.8, 57.5 and 52.2%, respectively. The anticonvulsants produced a stable preventive effect more rapidly (within the first 2-3 months of the treatment) as compared to LC. CRB had a more pronounced preventive efficacy in atypical affective and schizoaffective psychoses as well as in depressions, particularly in those with predominance of anxiety. As for its activity profile, SV approximated LC and was more effective in psychic endogenomorphous variants of MDP with a typical circadian vital symptom-complex. Unlike LC, the anticonvulsants demonstrated a well-defined capacity to interrupt the continual course of circulatory disorders including the "rapid cyclicity" phenomenon.

摘要

为明确心境正常药物预防性使用的不同适应证,对3组具有相当时相性内源性精神病主要临床及病史特征的患者进行了一项前瞻性研究。这些患者接受碳酸锂(LC,30例)、卡马西平(CRB,30例)和丙戊酸钠(SV,28例)治疗不少于1年。结果发现,所有药物均表现出同等程度的显著预防作用。在接受LC治疗时,情感症状总持续时间的年均减少幅度为49.3%,CRB为55.9%,SV为45.6%;发作频率分别降低了53.8%、57.5%和52.2%。与LC相比,抗惊厥药物起效更快(在治疗的前2 - 3个月内),能产生稳定的预防效果。CRB在非典型情感性和分裂情感性精神病以及抑郁症中,尤其是伴有焦虑为主的情况下,预防效果更为显著。就其活性谱而言,SV与LC相近,在具有典型昼夜生命症状复合体的MDP精神内源性变型中更有效。与LC不同,抗惊厥药物表现出明确的能力来中断包括“快速循环”现象在内的循环障碍的持续病程。

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