Small J G, Klapper M H, Marhenke J D, Milstein V, Woodham G C, Kellams J J
Indiana University School of Medicine, Department of Psychiatry, Larue D. Carter Memorial Hospital, Indianapolis, IN 46202, USA.
Psychopharmacol Bull. 1995;31(2):265-72.
Hospitalized manic patients were withdrawn from psychoactive medications for 2 weeks after which they were randomized to double-blind treatment with carbamazepine plus lithium [CBZ-Li] or haloperidol plus lithium [HAL-Li] with benztropine. Unit dosages of Li 300 mg, CBZ 200 mg and HAL 2 mg were titrated to therapeutic plasma levels and maintained for 8 weeks. No rescue medications were permitted after 3 weeks. Standard ratings of psychopathology and side effects were accomplished weekly. Sixty patients entered the study but only 33 remained for randomization after drug washout. By 8 weeks both groups were improved from baseline without statistically reliable differences between them. However HAL-Li patients had more extrapyramidal side effects that were major reasons for dropout, whereas CBZ-Li patients were more often noncompliant and initially required more rescue medications. We conclude that either combination treatment can be beneficial but CBZ-Li has the advantage because of fewer neurologic side effects.
住院的躁狂症患者停用精神活性药物2周，之后他们被随机分为两组，接受双盲治疗，一组使用卡马西平加锂盐[CBZ-Li]，另一组使用氟哌啶醇加锂盐[HAL-Li]并加用苯海索。锂盐的单位剂量为300毫克，卡马西平为200毫克，氟哌啶醇为2毫克，滴定至治疗性血浆水平并维持8周。3周后不允许使用急救药物。每周对精神病理学和副作用进行标准评分。60名患者进入研究，但药物洗脱后只有33名患者仍可进行随机分组。到8周时，两组患者均较基线有所改善，两组之间无统计学上的显著差异。然而，HAL-Li组患者有更多的锥体外系副作用，这是导致退出研究的主要原因，而CBZ-Li组患者更常出现不依从情况，且最初需要更多的急救药物。我们得出结论，两种联合治疗均有益，但CBZ-Li具有优势，因为其神经副作用较少。
