Brown E Sherwood, Perantie Dana C, Dhanani Nafisa, Beard Laura, Orsulak Paul, Rush A John
Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390-8849, United States.
J Affect Disord. 2006 Jul;93(1-3):219-22. doi: 10.1016/j.jad.2006.02.001. Epub 2006 Mar 7.
Bipolar disorder (BPD) is associated with high rates of substance abuse. We previously reported favorable results with lamotrigine in 30 patients with BPD and cocaine dependence. This report examines lamotrigine therapy in an additional 32 cocaine dependent patients. Data on these 32 participants are presented as a replication study. In addition, we extend the previous findings by combining data from both groups, and by exploring predictors of response.
Participants received a baseline evaluation and assessment for up to 36weeks with the 17-item Hamilton Rating Scale for Depression (HRSD(17)), Young Mania Rating Scale (YMRS), Brief Psychiatric Rating Scale (BPRS(18)), and Cocaine Craving Questionnaire (CCQ). Urine samples were obtained, and participants reported drug use during the previous week.
In the replication sample (n=32), significant improvements were observed in HRSD(17), YMRS, BPRS(18), and CCQ (baseline to exit), as well as on dollars/week spent on cocaine. In the extension study, the original sample (n=30) and the replication sample (n=32) were combined for a total of 62 participants in the intent-to-treat sample. HRSD(17), YMRS, BPRS(18), and CCQ scores, as well as dollars spent on cocaine, decreased significantly.
The study has an open-label, uncontrolled design.
Lamotrigine treatment was associated with significant improvements in mood, drug craving, and drug use. Controlled trials are needed.
双相情感障碍（BPD）与药物滥用的高发生率相关。我们之前报道了拉莫三嗪治疗30例双相情感障碍合并可卡因依赖患者取得了良好效果。本报告探讨拉莫三嗪对另外32例可卡因依赖患者的治疗情况。这32名参与者的数据作为一项重复研究呈现。此外，我们通过合并两组数据并探索反应预测因素来扩展先前的研究结果。
参与者接受基线评估，并使用17项汉密尔顿抑郁评定量表（HRSD(17)）、杨氏躁狂评定量表（YMRS）、简明精神病评定量表（BPRS(18)）和可卡因渴求问卷（CCQ）进行长达36周的评估。采集尿液样本，参与者报告前一周的药物使用情况。
在重复样本（n = 32）中，HRSD(17)、YMRS、BPRS(18)和CCQ（从基线到结束）以及每周花在可卡因上的费用均有显著改善。在扩展研究中，将原始样本（n = 30）和重复样本（n = 32）合并，意向性治疗样本共有62名参与者。HRSD(17)、YMRS、BPRS(18)和CCQ评分以及花在可卡因上的费用均显著下降。
该研究采用开放标签、非对照设计。
拉莫三嗪治疗与情绪、药物渴求及药物使用的显著改善相关。需要进行对照试验。
