van Scheyen J D, van Kammen D P
Arch Gen Psychiatry. 1979 May;36(5):560-5. doi: 10.1001/archpsyc.1979.01780050070008.
Manic behavior during randomly assigned treatment with clomipramine (chlorimipramine) or amitriptyline hydrochloride developed in seven of 50 hospitalized unipolar depressed patients. Six of the 25 clomipramine-treated patients became manic. Only one patient in the amitriptyline-treated group developed manic behavior. The switch into mania occurred at the mean age of 63, much later than the reported age of risk for mania. Significant correlations were observed between the age at onset of mania, the number of days of clomipramine treatment, and the duration of the manic episode. We hypothesize that such a switch into mania in unipolar patients is triggered by the psychopharmacological effect of clomipramine through an alleged change in activity of the central dopamine and serotonin systems.
在50名住院的单相抑郁症患者中，随机接受氯米帕明（氯丙咪嗪）或盐酸阿米替林治疗期间，有7名患者出现躁狂行为。接受氯米帕明治疗的25名患者中有6名出现躁狂。接受阿米替林治疗的组中只有1名患者出现躁狂行为。躁狂发作的平均年龄为63岁，比报道的躁狂发病风险年龄要晚得多。在躁狂发作年龄、氯米帕明治疗天数和躁狂发作持续时间之间观察到显著相关性。我们推测，单相患者出现这种躁狂转变是由氯米帕明的精神药理作用引发的，这一作用据称是通过中枢多巴胺和5-羟色胺系统活性的改变来实现的。
