Post Robert M, Ostacher Michael J, Singh Vivek
From the Department of Psychiatry, George Washington University School of Medicine, Washington, DC, and the Bipolar Collaborative Network, Bethesda, Maryland.
J Clin Psychiatry. 2014 Nov;75(11):e30. doi: 10.4088/JCP.13095tx2cj.
Few studies have examined the decision-making process for selecting a mood stabilizer or antipsychotic for patients with bipolar disorder. Despite a lack of evidence regarding their efficacy, conventional unimodal antidepressants continue to be used in bipolar treatment regimens. This article examines pharmacologic principles that can facilitate the evidence-based use of mood stabilizers and antipsychotics in patients with bipolar disorder. Choosing therapies for the maintenance of bipolar disorder, clinical decision making upon observation of a partial response, the use of combination therapies, and benefit/harm considerations when choosing a treatment for bipolar depression will be reviewed.
很少有研究探讨为双相情感障碍患者选择心境稳定剂或抗精神病药物的决策过程。尽管缺乏关于其疗效的证据，但传统的单药抗抑郁药仍继续用于双相情感障碍的治疗方案中。本文探讨了有助于循证使用心境稳定剂和抗精神病药物治疗双相情感障碍患者的药理学原理。还将综述双相情感障碍维持治疗的疗法选择、观察到部分缓解后的临床决策、联合疗法的使用以及选择双相抑郁治疗方法时的获益/风险考量。
