Patel Nick C, Keck Paul E
University of Cincinnati, College of Pharmacy and Department of Psychiatry, College of Medicine, 3225 Eden Avenue, PO Box 670004, Cincinnati, OH 45267-0004, USA.
Expert Rev Neurother. 2006 Aug;6(8):1129-38. doi: 10.1586/14737175.6.8.1129.
Atypical antipsychotics have been increasingly shown to have efficacy in the treatment of various phases of bipolar disorder. Ziprasidone acts primarily through serotonergic and dopaminergic receptor antagonism, and exerts effects as an inhibitor of serotonin and norepinephrine reuptake. Ziprasidone exhibits dose proportional, linear changes in exposure and is hepatically metabolized primarily by aldehyde oxidase. In studies of patients with acute manic or mixed episodes, treatment with ziprasidone monotherapy or in combination with lithium, resulted in rapid symptom improvement and was generally well tolerated. Results from open-label extension studies of ziprasidone indicate continued improvement in manic symptoms. Preliminary data in pediatric patients with bipolar disorder also suggest it may be efficacious in this population. Ziprasidone is considered as a first-line treatment option in patients with bipolar manic or mixed episodes, with or without psychosis and displays a favorable side-effect profile.
非典型抗精神病药物越来越多地被证明在双相情感障碍的各个阶段治疗中具有疗效。齐拉西酮主要通过血清素能和多巴胺能受体拮抗作用发挥作用，并作为血清素和去甲肾上腺素再摄取抑制剂发挥效应。齐拉西酮在暴露量方面呈现剂量成正比的线性变化，主要通过醛氧化酶在肝脏进行代谢。在急性躁狂或混合发作患者的研究中，齐拉西酮单药治疗或与锂联合治疗可使症状迅速改善，且总体耐受性良好。齐拉西酮开放标签扩展研究的结果表明躁狂症状持续改善。双相情感障碍儿科患者的初步数据也表明该药在该人群中可能有效。齐拉西酮被视为双相躁狂或混合发作患者（无论有无精神病性症状）的一线治疗选择，且副作用较小。
