Bertschy G, Luxembourger I, Bizouard P, Vandel S, Allers G, Volmat R
Service de Psychiatrie, CHU Saint-Jacques, Besançon.
Encephale. 1990 Sep-Oct;16(5):405-9.
The authors relate eight cases of amineptine dependency collected between 1980 and 1988 in 7 women and 1 man treated in the CHU of Besançon (France). The pharmacodependency appeared to be limited mainly to an abuse and a psychic dependence, i.e. a compulsive need to use the drug on a periodic (two cases) or continuing (six cases) basis in order to experience its psychomotor stimulant like effect. The used dosages ranged between 1,000 and 2,500 mg per day. The daily dose was divided into little doses, every hour for example. The induction modality was progressive during weeks or months and a stable dose period was then encountered. In one patient only, we observed a progressive increase of the dose without stabilisation of the dose. The withdrawal of amineptine was obtained without problem except in 2 cases where we observed clinical manifestations of anxiety, psychomotor agitation or bulimia during one day. Four years after the beginning, amineptine dependence was still present in 2 patients. In 4 patients we obtained an interruption of the amineptine pharmacodependency for one to three years. We did not see again the two remaining patients. In two cases, the main diagnosis, according to DSM III, was a major personality disorder (borderline). In the six other cases the diagnosis was a bipolar affective disorder (including four cases with only hypomanic episodes only). In these six patients the main characteristic of their affective illness was the association with other psychiatric disorders, especially personality disorders, such as borderline personality in one case and atypical personality with uncontrolled behavior as the main feature, in the 5 other patients.(ABSTRACT TRUNCATED AT 250 WORDS)
作者报告了1980年至1988年间在法国贝桑松大学中心医院治疗的8例安咪奈丁依赖病例,其中7名女性和1名男性。药物依赖似乎主要局限于滥用和精神依赖,即有周期性(2例)或持续性(6例)使用该药物的强迫性需求,以便体验其类似精神运动兴奋剂的效果。使用剂量为每天1000至2500毫克。每日剂量分为小份,例如每小时服用一次。诱导方式在数周或数月内逐渐增加,然后进入稳定剂量期。仅在1例患者中,我们观察到剂量逐渐增加但未达到稳定状态。停用安咪奈丁没有问题,除了2例患者在停药一天时出现焦虑、精神运动性激越或贪食的临床表现。开始用药四年后,仍有2例患者存在安咪奈丁依赖。4例患者的安咪奈丁药物依赖中断了1至3年。我们没有再见到其余2例患者。根据《精神疾病诊断与统计手册》第三版,2例患者的主要诊断为重度人格障碍(边缘型)。其他6例患者的诊断为双相情感障碍(包括4例仅有轻躁狂发作的病例)。在这6例患者中,其情感疾病的主要特征是与其他精神障碍相关,尤其是人格障碍,例如1例为边缘型人格,其他5例为以行为失控为主要特征的非典型人格。(摘要截选至250字)