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[抗癫痫药物对冲动障碍的控制作用]

[Antiepileptic drugs in the control of the impulses disorders].

作者信息

Roncero C, Rodríguez-Urrutia A, Grau-López L, Casas M

机构信息

Servicio de Psiquiatría, Escuela de Enfermería 5 planta, Hospital Vall Hebrón, Paseo de Vall Hebrón 119-129, 08035 Barcelona, Spain.

出版信息

Actas Esp Psiquiatr. 2009 Jul-Aug;37(4):205-12.

Abstract

The disorders classified as control of the impulses; explosive intermittent disorder, pathological gambling, kleptomania, pyromania, pathological gambling, hair pullers, compulsive purchases, skin picking and onychophagia are a heterogeneous set of clinical entities, most of them with little prevalence. Nevertheless, they cause important personal and social dysfunctions and present great comorbidity with other psychiatric disorders. Antipsychotics, antidepressive agents, serotoninergic agonists, naltrexone, beta blockers antiandrogen, lithium and anticonvulsants have been used in their pharmacological treatment. Currently, interest is growing on the use of the antiepileptics because their possible usefulness has been described in these disorders. However, the neurobiological effects are only partially known in some cases. We have reviewed the literature regarding the treatment of these disorders with mood stabilizers, (lithium, carbamazepine, valproate, phenitoin, oxcarbacepin, topiramate, lamotrigin, leviteracetam) and have described those studies on which the current knowledge and evidence are based. The results must be considered as provisional and must be updated in the future, since they are mostly based on case reports, case series or opened clinical trials, their being little knowledge based on double blind clinical trials.

摘要

被归类为冲动控制障碍的疾病包括

爆发性间歇性障碍、病理性赌博、偷窃癖、纵火癖、病理性赌博、拔毛癖、强迫性购物、皮肤搔抓症和咬甲癖,它们是一组异质性的临床实体,大多数发病率较低。然而,它们会导致重要的个人和社会功能障碍,并与其他精神疾病有很高的共病率。抗精神病药、抗抑郁药、5-羟色胺能激动剂、纳曲酮、β受体阻滞剂、抗雄激素药物、锂盐和抗惊厥药已被用于其药物治疗。目前,人们对使用抗癫痫药物的兴趣日益增加,因为在这些疾病中已描述了它们可能的效用。然而,在某些情况下,其神经生物学效应仅部分为人所知。我们回顾了有关使用心境稳定剂(锂盐、卡马西平、丙戊酸盐、苯妥英、奥卡西平、托吡酯、拉莫三嗪、左乙拉西坦)治疗这些疾病的文献,并描述了那些作为当前知识和证据基础的研究。这些结果必须被视为临时的,并且未来必须更新,因为它们大多基于病例报告、病例系列或开放临床试验,基于双盲临床试验的知识很少。

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