Grunze H, Schlösser S, Amann B, Walden J
Department of Psychiatry, University of Munich, Germany.
Dialogues Clin Neurosci. 1999 Jun;1(1):24-40. doi: 10.31887/DCNS.1999.1.1/hgrunze.
Although much progress has been made in successfully treating bipolar disorder, there is increasing awareness of the limitations of traditional treatment regimens such as lithium and neuroleptics. The large family of anticonvulsant drugs, however, appears to be capable of providing new treatment options, not only as medication of second choice in patients refractory to treatment, but often as a treatment standard with high efficacy and low incidence of side effects. Besides established mood stabilizers such as carbamazepine and valproate, new antiepileptic drugs are entering the field with promising initial results in the treatment of bipolar patients. Furthermore, bringing to light the mechanisms of action of anticonvulsants and the similarities between anticonvulsants effective in bipolar disorder may also deepen our understanding of the pathophysiological basis of the disorder.
尽管在双相情感障碍的成功治疗方面已经取得了很大进展,但人们越来越意识到传统治疗方案(如锂盐和抗精神病药物)的局限性。然而,大量的抗惊厥药物似乎能够提供新的治疗选择,不仅可作为对治疗难治患者的二线用药,而且常常作为具有高效和低副作用发生率的治疗标准。除了已有的心境稳定剂如卡马西平和丙戊酸盐外,新型抗癫痫药物也正在进入该领域,在双相情感障碍患者的治疗中取得了令人鼓舞的初步成果。此外,揭示抗惊厥药物的作用机制以及双相情感障碍有效抗惊厥药物之间的相似性,也可能加深我们对该疾病病理生理基础的理解。