Departments of aTranslational Research and New Technologies in Medicine and Surgery bClinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Int Clin Psychopharmacol. 2013 Nov;28(6):305-11. doi: 10.1097/YIC.0b013e3283642348.
The present study aimed to identify the prescribing patterns of lithium or of lithium+valproate in 75 bipolar I outpatients in a manic or a mixed phase within a naturalistic setting. The differences between the two treatments and the correlation between serum lithium levels and response were also examined. The results showed that patients with lithium levels of 0.60 mEq/l or more had higher remission rates and greater symptom reduction than the other patients. Patients on lithium and valproate showed greater improvement in mixed, anxiety, and psychotic symptoms than those on lithium only, as assessed by the Clinical Global Impression-Bipolar version scale scores. Finally, our findings suggest that a range of lithium levels between 0.40 and 0.60 mEq/l, albeit below the therapeutic range, seems sufficient to maintain a good effect when lithium is coadministered with valproate.
本研究旨在确定在自然环境中，75 名双相 I 型躁狂或混合相门诊患者中锂或锂+丙戊酸盐的处方模式。还检查了两种治疗方法之间的差异以及血清锂水平与反应之间的相关性。结果表明，锂水平为 0.60mEq/l 或更高的患者缓解率更高，症状改善程度大于其他患者。与单独使用锂相比，锂和丙戊酸盐治疗的患者在混合、焦虑和精神病症状方面的改善更大，这一点可通过临床总体印象-双相版本量表评分来评估。最后，我们的发现表明，当锂与丙戊酸盐联合使用时，0.40 至 0.60mEq/l 之间的一系列锂水平（尽管低于治疗范围）似乎足以维持良好的效果。
