Greendyke R M, Gulya A
Neurobehavioral Intensive Care Unit, Veterans Administration Medical Center, Canandaigua, NY 14424.
J Clin Psychiatry. 1988 Mar;49(3):105-7.
Twenty-six male patients with intermittent explosive disorder secondary to organic brain disease were studied. Each had been treated with long-term administration of thioridazine, haloperidol, phenytoin, and/or phenobarbital, either singly or in combination. The effect of adding increasing doses of pindolol--a beta-adrenergic blocking agent previously demonstrated to be effective in the treatment of intermittent explosive disorder--on serum levels of each long-term medication was determined. Moderate, dose-related increases in serum levels of thioridazine and two of its metabolites were found when pindolol was added. Conversely, higher-than-expected serum pindolol levels occurred in patients receiving thioridazine. No serum level increases were found for haloperidol, phenytoin, or phenobarbital when pindolol was added to each of these drugs individually, but serum phenytoin levels did rise in two patients receiving all three drugs simultaneously when pindolol was added. Three treatment failures with pindolol occurred in association with low serum pindolol levels.
对26例继发于器质性脑疾病的间歇性暴发性障碍男性患者进行了研究。每位患者都曾单独或联合长期服用过硫利达嗪、氟哌啶醇、苯妥英和/或苯巴比妥。研究了添加递增剂量的吲哚洛尔（一种先前已证明对治疗间歇性暴发性障碍有效的β-肾上腺素能阻滞剂）对每种长期用药血清水平的影响。添加吲哚洛尔后，发现硫利达嗪及其两种代谢物的血清水平出现中度的、与剂量相关的升高。相反，接受硫利达嗪治疗的患者血清吲哚洛尔水平高于预期。当分别向氟哌啶醇、苯妥英或苯巴比妥中添加吲哚洛尔时，未发现这些药物的血清水平升高，但在同时接受这三种药物治疗的两名患者中添加吲哚洛尔后，血清苯妥英水平确实升高了。3例使用吲哚洛尔治疗失败与血清吲哚洛尔水平低有关。
