Robakis Thalia K, Holtzman Jessie, Stemmle Pascale G, Reynolds-May Margaret F, Kenna Heather A, Rasgon Natalie L
Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, United States.
Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, United States.
J Affect Disord. 2015 Apr 1;175:108-15. doi: 10.1016/j.jad.2014.12.040. Epub 2014 Dec 24.
To examine the occurrence of menstrually-entrained mood cycling in women with treated bipolar disorder as compared to healthy controls, and to explore whether there is a specific effect of lamotrigine in dampening menstrually-entrained cyclicity of mood.
Observational comparison study of daily self-ratings of mood, sleep, and insomnia obtained over a mean of four menstrual cycles in 42 women with bipolar disorder taking lamotrigine as part of their treatment, 30 women with bipolar disorder receiving mood stabilizing regimens without lamotrigine, and 13 healthy controls, all with physiological menstrual cycles. Additional exploratory analysis of interactions between psychopharmacological regimen and hormonal contraceptive use in the group of women with bipolar disorder, with the addition of 19 women with bipolar disorder who were using hormonal contraceptives.
Women treated for bipolar disorder manifested lower average mood, longer average nightly sleep duration, and greater fluctuations in mood and sleep across menstrual cycle phases than healthy controls. Women with bipolar disorder who were taking lamotrigine had less fluctuation in mood both within and across menstrual cycle phases, and were more similar to the control group than to women with bipolar disorder who were not taking lamotrigine in this respect. In addition, medications with GABA-A receptor modulating effects were found to result in improved mood ratings when combined with hormonal contraceptives.
Menstrually-entrained mood fluctuation is present in women treated for bipolar disorder to a greater degree than in healthy controls. Lamotrigine may be of use in mitigating this fluctuation. GABA-A receptor modulators in general may act synergistically with hormonal contraceptives to enhance mood in women with bipolar disorder; this hypothesis merits further study.
与健康对照者相比，研究接受治疗的双相情感障碍女性中月经周期相关的情绪波动情况，并探讨拉莫三嗪在抑制月经周期相关情绪波动方面是否有特定作用。
对42名正在服用拉莫三嗪进行治疗的双相情感障碍女性、30名接受不含拉莫三嗪的心境稳定剂治疗方案的双相情感障碍女性以及13名健康对照者进行观察性比较研究，所有研究对象均有生理性月经周期，在平均四个月经周期内每日进行情绪、睡眠和失眠的自我评分。对双相情感障碍女性组中精神药理学治疗方案与激素避孕药使用之间的相互作用进行额外的探索性分析，该组新增了19名正在使用激素避孕药的双相情感障碍女性。
与健康对照者相比，接受双相情感障碍治疗的女性平均情绪较低，平均夜间睡眠时间较长，且在月经周期各阶段情绪和睡眠的波动更大。服用拉莫三嗪的双相情感障碍女性在月经周期内及不同月经周期阶段的情绪波动较小，在这方面与对照组更相似，而与未服用拉莫三嗪的双相情感障碍女性不同。此外，发现具有γ-氨基丁酸A（GABA-A）受体调节作用的药物与激素避孕药联合使用时可改善情绪评分。
接受双相情感障碍治疗的女性中，月经周期相关的情绪波动比健康对照者更明显。拉莫三嗪可能有助于减轻这种波动。一般来说，GABA-A受体调节剂可能与激素避孕药协同作用，改善双相情感障碍女性的情绪；这一假设值得进一步研究。
