Muneoka Katsumasa, Kon Katsushi, Kawabe Masaharu, Ui Rui, Miura Taichi, Iimura Touta, Kimura Shou
Kimura Hospital, 6-19 Higashi-Honcho, Chuo-Ku, Chiba, Chiba-shi 260-0004, Japan ; Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan.
Case Rep Med. 2012;2012:736521. doi: 10.1155/2012/736521. Epub 2012 Sep 23.
Two cases of patients experienced subsyndromal depression after manic or mixed hypomanic and depressive episodes due to bipolar I (case 1) and II (case 2) disorders prior to the use of lamotrigine. Case 1 showed episodes of mood switching induced by antidepressants and seasonal mood instability. Case 2 showed hippocampal atrophy and a persistent dull headache that preceded the use of lamotrigine. Both were successfully treated with add-on lamotrigine therapy, and the dull headache was effectively treated with olanzapine. Both patients improved in social activity and work performance after these add-on treatments. Thus, add-on treatment with lamotrigine alone or in combination with olanzapine was an effective strategy to improve the quality of life in bipolar depression. Subsyndromal depression that present after the disappearance of the manic or mixed state was suggested to be practical indication for the use of lamotrigine.
两例患者在使用拉莫三嗪之前，因双相I型（病例1）和II型（病例2）障碍经历了躁狂或混合性轻躁狂及抑郁发作后的亚综合征抑郁。病例1表现出由抗抑郁药诱发的情绪转换发作和季节性情绪不稳定。病例2在使用拉莫三嗪之前出现海马萎缩和持续性钝痛。两者均通过加用拉莫三嗪治疗成功，且钝痛通过奥氮平得到有效治疗。在这些加用治疗后，两名患者的社交活动和工作表现均有所改善。因此，单独使用拉莫三嗪或与奥氮平联合加用治疗是改善双相抑郁患者生活质量的有效策略。在躁狂或混合状态消失后出现的亚综合征抑郁被认为是使用拉莫三嗪的实际指征。
