Kramlinger K G, Post R M
Biological Psychiatry Branch, NIMH, Bethesda, MD 20892.
Am J Psychiatry. 1990 May;147(5):615-20. doi: 10.1176/ajp.147.5.615.
In view of the increasing use of lithium-carbamazepine combination therapy for refractory psychiatric disorders, the authors assessed the clinical laboratory effects of adding lithium to carbamazepine in 23 patients with affective disorders. Lithium produced a robust reversal of carbamazepine-induced leukopenia, increasing WBCs, predominantly neutrophils, to levels significantly above placebo baseline values. The combination produced additive antithyroidal effects, resulting in greater decreases in T4 and free T4 than with carbamazepine alone; the addition of lithium was associated with the emergence of a modestly higher TSH level. The authors discuss clinical and theoretical implications of these findings.
鉴于锂盐与卡马西平联合治疗难治性精神障碍的应用日益增多，作者评估了在23例情感障碍患者中加用锂盐至卡马西平治疗时的临床实验室效应。锂盐显著逆转了卡马西平所致的白细胞减少，使白细胞（主要是中性粒细胞）增加至显著高于安慰剂基线值的水平。联合用药产生了相加的抗甲状腺效应，导致T4和游离T4水平较单用卡马西平时有更大幅度的下降；加用锂盐与促甲状腺激素（TSH）水平略有升高有关。作者讨论了这些发现的临床及理论意义。
