Rybakowski Janusz K, Ferensztajn-Rochowiak Ewa
Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
Expert Rev Neurother. 2023 Feb;23(2):157-167. doi: 10.1080/14737175.2023.2181076. Epub 2023 Feb 21.
Lithium is one of the most important drugs for the treatment of mood disorders. The appropriate guidelines can ensure that more patients benefit from its use in a personalized way.
This manuscript provides an update on the application of lithium in mood disorders, including prophylaxis of bipolar and unipolar mood disorder, treatment of acute manic and depressive episodes, augmentation of antidepressants in treatment-resistant depression, and use of lithium in pregnancy and the postpartum period.
Lithium remains the gold standard for the prevention of recurrences in bipolar mood disorder. For long-term treatment/management of bipolar mood disorder, clinicians should also consider lithium's anti-suicidal effect. Furthermore, after prophylactic treatment, lithium may also be augmented with antidepressants in treatment-resistant depression. There have also been some demonstration of lithium having some efficacy in acute episodes of mania and bipolar depression as well as in the prophylaxis of unipolar depression.
锂是治疗情绪障碍最重要的药物之一。适当的指南可确保更多患者以个性化方式从其使用中获益。
本手稿提供了锂在情绪障碍中应用的最新情况,包括双相和单相情绪障碍的预防、急性躁狂和抑郁发作的治疗、难治性抑郁症中抗抑郁药的增效,以及锂在孕期和产后的使用。
锂仍然是双相情绪障碍预防复发的金标准。对于双相情绪障碍的长期治疗/管理,临床医生还应考虑锂的抗自杀作用。此外,在预防性治疗后,锂也可与抗抑郁药联合用于难治性抑郁症。在急性躁狂和双相抑郁发作以及单相抑郁的预防中,也有一些证据表明锂有一定疗效。