Shen Yu-Chih
Department of Psychiatry, Tzu-Chi General Hospital, Hualien City, Taiwan, ROC.
World J Biol Psychiatry. 2008;9(2):147-9. doi: 10.1080/15622970701332520.
Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder characterized by midlife onset, progressive course and a combination of motor, cognitive and psychiatric symptoms. Since dysregulation of the glutamate/calcium signalling pathway is beginning to emerge as a potential cause of neuron degeneration, antagonists of glutamate pathways such as lamotrigine, may have beneficial value for treatment of HD. We describe the use of lamotrigine in the treatment of an HD patient with motor abnormality (choreoathetoidic movements) complicated by psychiatric abnormalities (depression, severe mood swing and recurrent high risk of suicidal attempts). The patient's depression, severe mood swing and choreoathetoidic movements significantly improved with 300 mg/day of lamotrigine. Experience from our patient suggests that lamotrigine might be effective in treating HD patients with motor and mood symptoms. Further controlled studies are warranted to confirm its efficacy in patients of this type.
亨廷顿舞蹈症(HD)是一种常染色体显性神经退行性疾病,其特征为中年发病、病程呈进行性,且伴有运动、认知和精神症状。由于谷氨酸/钙信号通路失调开始被视为神经元变性的一个潜在原因,谷氨酸通路拮抗剂如拉莫三嗪,可能对亨廷顿舞蹈症的治疗具有有益价值。我们描述了拉莫三嗪在治疗一名患有运动异常(舞蹈手足徐动症)并伴有精神异常(抑郁、严重情绪波动和反复出现自杀企图高风险)的亨廷顿舞蹈症患者中的应用。该患者每日服用300毫克拉莫三嗪后,其抑郁、严重情绪波动和舞蹈手足徐动症有显著改善。我们这位患者的经验表明,拉莫三嗪可能对治疗伴有运动和情绪症状的亨廷顿舞蹈症患者有效。有必要进行进一步的对照研究,以证实其对这类患者的疗效。