Department of Psychiatry, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA.
Epilepsy Behav. 2011 Feb;20(2):386-9. doi: 10.1016/j.yebeh.2010.11.014. Epub 2010 Dec 28.
Antiepileptic drugs are effective psychotropics, especially for bipolar disorder, which leads to their use off-label in treatment-refractory cases. A recent publication suggests that rufinamide may be beneficial adjunctively for bipolar disorder with comorbid psychopathology. This report addresses two negative cases with significant psychiatric adverse effects: increased depression, agitation, and activation of suicidal ideation. These findings suggest that adjunctive rufinamide may lead to increased suicidal ideation in patients with treatment-refractory bipolar disorder. Secondary to the course of severe bipolar disorder, rufinamide cannot be specifically implicated; however, clinicians should be aware of this potential significant adverse effect and monitor high-risk patients. Further studies are required to address rufinamide treatment efficacy and severity of adverse effects in patients with bipolar disorder.
抗癫痫药物是有效的精神药物，尤其对双相情感障碍有效，这导致它们在治疗抵抗的病例中被超适应证使用。最近的一篇出版物表明，鲁非酰胺可能对伴有共病精神病理学的双相情感障碍有辅助治疗作用。本报告介绍了两例具有显著精神不良反应的阴性病例：抑郁、激越和自杀意念的激活增加。这些发现表明，辅助鲁非酰胺可能会导致治疗抵抗的双相情感障碍患者自杀意念增加。由于严重双相情感障碍的病程，不能具体牵连鲁非酰胺；然而，临床医生应该意识到这种潜在的严重不良反应，并监测高危患者。需要进一步的研究来解决双相情感障碍患者的鲁非酰胺治疗效果和不良反应的严重程度。
