Schreiner Andreas
Psychiatr Prax. 2006 Mar;33 Suppl 1:S12-7. doi: 10.1055/s-2005-867024.
In patients with bipolar disorder antipsychotics are frequently used for the treatment of acute manic episodes, either in monotherapy, in addition to a mood stabilizer or in patients refractory to lithium or other mood stabilizers. However, a number of studies demonstrated that the use of conventional neuroleptics is restricted -- particularly for long-term treatment and relapse prevention in bipolar disorder -- due to their side effect profile and their potential to induce or worsen depressive symptoms. In contrast, atypical antipsychotics have a better tolerability profile and fewer extrapyramidal side effects. A number of clinical studies showed that the atypical antipsychotic risperidone was effective and well tolerated in the treatment of bipolar mania. This was reported both for the treatment of acute episodes and for the maintenance therapy. Recent data suggest that risperidone can be used effectively either in addition to or even instead of a mood stabilizer. This review summarizes the available literature on risperidone in the treatment of bipolar disorders.
在双相情感障碍患者中,抗精神病药物常用于治疗急性躁狂发作,可单独使用、与心境稳定剂联合使用,或用于对锂盐或其他心境稳定剂治疗无效的患者。然而,多项研究表明,由于传统抗精神病药物的副作用及其诱发或加重抑郁症状的可能性,其应用受到限制——尤其是在双相情感障碍的长期治疗和预防复发方面。相比之下,非典型抗精神病药物具有更好的耐受性,锥体外系副作用较少。多项临床研究表明,非典型抗精神病药物利培酮在治疗双相躁狂方面有效且耐受性良好。这在急性发作治疗和维持治疗中均有报道。最新数据表明,利培酮可有效用于心境稳定剂联合治疗,甚至可替代心境稳定剂。本综述总结了利培酮治疗双相情感障碍的现有文献。