Janicak P G, Bresnahan D B, Sharma R, Davis J M, Comaty J E, Malinick C
Illinois State Psychiatric Institute, Chicago.
J Clin Psychopharmacol. 1988 Feb;8(1):33-7.
High potency neuroleptics have been advocated for acute mania because their side effect profile may allow for a more rapid dose escalation and symptom resolution. Low potency neuroleptics have also been advocated because their sedative properties might better calm the acutely agitated manic patient. The authors tested these hypotheses using a double-blind design comparing thiothixene with chlorpromazine in 29 manic patients on a standard dose of lithium. They found that thiothixene and chlorpromazine produced identical rates and degree of improvement, that side effect profiles differed for each drug but did not affect overall clinical response, and that most patients had a good response on much lower than expected doses. The implications for less aggressive use of neuroleptics to treat mania are discussed.
高效能抗精神病药物已被推荐用于治疗急性躁狂症，因为其副作用特征可能允许更快地增加剂量并缓解症状。低效能抗精神病药物也被推荐，因为其镇静特性可能更好地使急性躁狂且烦躁不安的患者平静下来。作者采用双盲设计，将29名服用标准剂量锂盐的躁狂症患者的硫利达嗪与氯丙嗪进行比较，以验证这些假设。他们发现硫利达嗪和氯丙嗪产生的改善率和改善程度相同，每种药物的副作用特征不同，但不影响总体临床反应，并且大多数患者在远低于预期剂量时就有良好反应。文中讨论了减少使用抗精神病药物积极治疗躁狂症的意义。
