Nasrallah Henry A, Ketter Terence A, Kalali Amir H
Department of Psychiatry, University of Cincinnati, Cincinnati, OH 45267-0559, USA.
J Affect Disord. 2006 Oct;95(1-3):69-78. doi: 10.1016/j.jad.2006.04.030. Epub 2006 Jun 15.
There are an increasing number of pharmacologic therapies for bipolar disorder. Two of these agents, the anticonvulsants carbamazepine (CBZ) and valproate (VPA), were first developed over 30 years ago for the treatment of epilepsy, and subsequent studies demonstrated that they are also effective in the treatment of acute mania and suggest efficacy as maintenance therapy in bipolar disorder. Because VPA and CBZ have been in use for many years, the psychiatric community is familiar with the adverse event profiles of these agents. A review of the clinical data evaluating VPA and CBZ monotherapy for the treatment of acute mania suggests that VPA and CBZ are similarly effective in acute mania. However, when their respective adverse event profiles are considered, VPA may be more tolerable than CBZ for short-term use, while CBZ may be better suited for long-term therapy. Controlled and direct comparative studies, both short and long term, are needed to further clarify the differences between VPA and CBZ.
治疗双相情感障碍的药物疗法越来越多。其中两种药物，抗惊厥药卡马西平（CBZ）和丙戊酸盐（VPA），30多年前首次开发用于治疗癫痫，随后的研究表明它们在治疗急性躁狂症方面也有效，并提示对双相情感障碍有维持治疗的疗效。由于VPA和CBZ已使用多年，精神医学界熟悉这些药物的不良事件谱。一项评估VPA和CBZ单药治疗急性躁狂症的临床数据综述表明，VPA和CBZ在急性躁狂症中同样有效。然而，考虑到它们各自的不良事件谱，VPA短期使用可能比CBZ更耐受，而CBZ可能更适合长期治疗。需要进行短期和长期的对照及直接比较研究，以进一步阐明VPA和CBZ之间的差异。
