Glazer W M, Sheard M H
J Clin Psychiatry. 1982 Apr;43(4):134-6.
After a research diagnostic interview with 60 chronic outpatients clinically diagnosed as schizophrenic, the authors identified four patients who by retrospective history had had affective episodes at one time in their life and schizophrenic episodes at another. Lithium was substituted for antipsychotic medications and the patients were followed for 13 months. Two patients relapsed on lithium alone, one relapsed on no medications and one did well on lithium alone. The phenomenology observed in the three relapsing cases included: 1) RDC mania; 2) rapid onset with confusion; 3) sexually regressive behavior; and 4) improvement with reinitiation of antipsychotic medication. Caution is advised in the use of lithium alone for patients fitting this diagnostic description.
在对60名临床诊断为精神分裂症的慢性门诊患者进行研究诊断访谈后，作者确定了4名患者，根据回顾性病史，他们在一生中曾有过情感发作，在其他时间有过精神分裂症发作。用锂替代抗精神病药物，并对患者随访13个月。两名患者仅使用锂就复发了，一名患者未用药复发，一名患者仅使用锂效果良好。在三例复发病例中观察到的现象包括：1）《研究诊断标准》（RDC）中的躁狂症；2）快速起病伴意识模糊；3）性退行性行为；4）重新使用抗精神病药物后病情改善。对于符合这种诊断描述的患者，建议谨慎单独使用锂。
