Ukaegbu Chibuzo, Banks J Burton, Carter Nakia J, Goldman Larry S
Department of Family Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA.
J Fam Pract. 2008 Sep;57(9):606-8.
Antidepressants and lamotrigine are effective. Atypical antipsychotics, lithium, and anticonvulsants also may help. Antidepressants, including tricyclics and selective serotonin reuptake inhibitors (SSRIs), are useful adjuncts in short-term treatment of bipolar depression and have low rates of inducing mania (strength of recommendation [SOR]: 1 systematic review and randomized controlled trials [RCTs]). Lamotrigine is beneficial for both acute treatment of bipolar depression and prevention of recurrent episodes (SOR: 1 systematic review and 1 RCT). Some atypical antipsychotics alone (SOR: 2 RCTs) or in combination with antidepressants (SOR: 1 multicenter RCT) effectively treat acute bipolar depression. Lithium and anticonvulsants such as valproate also may be useful (SOR: limited number of studies with small sample sizes).
抗抑郁药和拉莫三嗪是有效的。非典型抗精神病药、锂盐和抗惊厥药也可能有帮助。抗抑郁药，包括三环类药物和选择性5-羟色胺再摄取抑制剂（SSRI），是双相抑郁短期治疗中的有用辅助药物，且诱发躁狂的发生率较低（推荐强度[SOR]：1项系统评价和随机对照试验[RCT]）。拉莫三嗪对双相抑郁的急性治疗和预防复发均有益（SOR：1项系统评价和1项RCT）。一些非典型抗精神病药单用（SOR：2项RCT）或与抗抑郁药联用（SOR：1项多中心RCT）可有效治疗急性双相抑郁。锂盐和丙戊酸盐等抗惊厥药也可能有用（SOR：样本量小的研究数量有限）。
