Sachs G S, Rosenbaum J F, Jones L
Clinical Psychopharmacology Unit, Massachusetts General Hospital, Boston 02176.
J Clin Psychopharmacol. 1990 Feb;10(1):42-7. doi: 10.1097/00004714-199002000-00008.
In light of the reported efficacy of clonazepam in treating acute mania, we conducted a retrospective review of clinical experience with this agent in maintenance treatment of patients with bipolar affective disorder. Twenty patients with bipolar affective disorder treated with adjunctive clonazepam were identified. A case vignette and summary data on all 20 patients are presented. Clonazepam had been prescribed, in a manner similar to neuroleptics, as part of the maintenance regimen and/or on an as needed basis for acute exacerbations. In six of 17 patients previously receiving combined lithium and neuroleptic treatment, clonazepam successfully replaced the neuroleptic. Overall, eight patients were rated much improved or very much improved, including three of the five cases initially rated most severely ill. Possible mechanisms and treatment strategies are discussed.
鉴于有报道称氯硝西泮在治疗急性躁狂方面有效，我们对该药物在双相情感障碍患者维持治疗中的临床经验进行了回顾性研究。确定了20例接受辅助性氯硝西泮治疗的双相情感障碍患者。呈现了所有20例患者的病例 vignette 和汇总数据。氯硝西泮已按照与抗精神病药物类似的方式，作为维持治疗方案的一部分和/或根据需要用于急性加重期。在17例先前接受锂盐和抗精神病药物联合治疗的患者中，有6例患者氯硝西泮成功替代了抗精神病药物。总体而言，8例患者被评为有很大改善或非常大的改善，包括最初评定为病情最严重的5例患者中的3例。讨论了可能的机制和治疗策略。
