Konovalov Sergiy, Muralee Sunanda, Tampi Rajesh R
Department of Psychiatry, Yale University School of Medicine, New Haven, U.S.A.
Int Psychogeriatr. 2008 Apr;20(2):293-308. doi: 10.1017/S1041610207006540. Epub 2007 Nov 30.
To review and summarize the currently available data on the use of anticonvulsant mood stabilizers (carbamazepine, valproic acid, gabapentin, lamotrigine, topiramate) in the treatment of behavioral and psychological symptoms of dementia (BPSD); to determine whether these medications can be recommended for routine clinical use.
Literature search in five databases (PubMed, MEDLINE, EMBASE, PsychINFO and COCHRANE collaboration) and analysis of the randomized controlled double-blinded clinical trials found therein.
A total of seven RCTs were identified (two for carbamazepine and five for valproate). One study showed statistically significant improvement of BPSD in the medication group in comparison to the placebo group; five studies showed no significant differences; one study showed statistically significant worsening of the symptoms in the medication group vs. placebo. The majority of the studies reported significantly more frequent adverse effects in the medication group.
Although clearly beneficial in some patients, anticonvulsant mood stabilizers cannot be recommended for routine use in the treatment of BPSD at the present time.
回顾并总结目前有关抗惊厥心境稳定剂（卡马西平、丙戊酸、加巴喷丁、拉莫三嗪、托吡酯）用于治疗痴呆的行为和心理症状（BPSD）的可用数据；确定这些药物是否可推荐用于常规临床治疗。
在五个数据库（PubMed、MEDLINE、EMBASE、PsychINFO和Cochrane协作网）中进行文献检索，并对其中找到的随机对照双盲临床试验进行分析。
共识别出七项随机对照试验（两项关于卡马西平，五项关于丙戊酸盐）。一项研究显示，与安慰剂组相比，用药组的BPSD有统计学意义的改善；五项研究显示无显著差异；一项研究显示用药组与安慰剂组相比症状有统计学意义的恶化。大多数研究报告用药组的不良反应明显更频繁。
尽管抗惊厥心境稳定剂对某些患者显然有益，但目前不推荐将其常规用于治疗BPSD。
