第一代和第二代心境稳定剂。
Mood Stabilizers of First and Second Generation.
作者信息
Rybakowski Janusz K
机构信息
Department of Adult Psychiatry, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
出版信息
Brain Sci. 2023 Apr 29;13(5):741. doi: 10.3390/brainsci13050741.
The topic of this narrative review is mood stabilizers. First, the author's definition of mood-stabilizing drugs is provided. Second, mood-stabilizing drugs meeting this definition that have been employed until now are described. They can be classified into two generations based on the chronology of their introduction into the psychiatric armamentarium. First-generation mood stabilizers (FGMSs), such as lithium, valproates, and carbamazepine, were introduced in the 1960s and 1970s. Second-generation mood stabilizers (SGMSs) started in 1995, with a discovery of the mood-stabilizing properties of clozapine. The SGMSs include atypical antipsychotics, such as clozapine, olanzapine, quetiapine, aripiprazole, and risperidone, as well as a new anticonvulsant drug, lamotrigine. Recently, as a candidate for SGMSs, a novel antipsychotic, lurasidone, has been suggested. Several other atypical antipsychotics, anticonvulsants, and memantine showed some usefulness in the treatment and prophylaxis of bipolar disorder; however, they do not fully meet the author's criteria for mood stabilizers. The article presents clinical experiences with mood stabilizers of the first and second generations and with "insufficient" ones. Further, current suggestions for their use in preventing recurrences of bipolar mood disorder are provided.
本叙述性综述的主题是心境稳定剂。首先，给出了作者对心境稳定药物的定义。其次，描述了迄今为止已使用的符合该定义的心境稳定药物。根据其引入精神科治疗药物库的时间顺序，它们可分为两代。第一代心境稳定剂（FGMSs），如锂盐、丙戊酸盐和卡马西平，于20世纪60年代和70年代被引入。第二代心境稳定剂（SGMSs）始于1995年，随着氯氮平心境稳定特性的发现。第二代心境稳定剂包括非典型抗精神病药物，如氯氮平、奥氮平、喹硫平、阿立哌唑和利培酮，以及一种新型抗惊厥药物拉莫三嗪。最近，一种新型抗精神病药物鲁拉西酮被提议作为第二代心境稳定剂的候选药物。其他几种非典型抗精神病药物、抗惊厥药物和美金刚在双相情感障碍的治疗和预防中显示出一定疗效；然而，它们并不完全符合作者对心境稳定剂的标准。本文介绍了第一代和第二代心境稳定剂以及“不充分”的心境稳定剂的临床经验。此外，还提供了目前关于它们用于预防双相情感障碍复发的建议。
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