Hayes S G
Department of Psychiatry, University of Southern California School of Medicine.
Ann Clin Psychiatry. 1993 Mar;5(1):35-44. doi: 10.3109/10401239309148922.
Despite an increasing literature demonstrating both acute and long-term positive psychopharmacological effects of both valproate and carbamazepine, phenytoin has remained a controversial intervention, and barbiturate anticonvulsants have generally received poor press with regard to psychotropic effects. In the present investigation, 27 seizure-free, affectively ill patients who received therapeutic trials of primidone and/or mephobarbital after failing on antidepressants, lithium, carbamazepine, valproate, and phenytoin were analyzed with regard to effects on illness severity and affective cycle rate over a period of as long as four years. Nine (33%) of the patients had a sustained positive therapeutic effect on affective state and/or psychotic symptoms to primidone and three (11%) had positive effects on mephobarbital after primidone failure. Four (15%) had brief positive effects that were not sustained, and the remaining 11 (41%) had no effects or negative effects to these agents. The theoretical and practical implications of this new and unexpected finding are discussed.
尽管越来越多的文献表明丙戊酸盐和卡马西平均具有急性和长期的积极精神药理作用，但苯妥英钠仍是一种有争议的干预措施，而巴比妥类抗惊厥药在精神otropic作用方面普遍评价不佳。在本研究中，对27名无癫痫发作、患有情感障碍的患者进行了分析，这些患者在抗抑郁药、锂盐、卡马西平、丙戊酸盐和苯妥英钠治疗失败后接受了扑米酮和/或美索比妥的治疗试验，观察了长达四年的时间里这些药物对疾病严重程度和情感周期率的影响。9名（33%）患者对扑米酮的情感状态和/或精神症状有持续的积极治疗效果，3名（11%）患者在扑米酮治疗失败后对美索比妥有积极效果。4名（15%）患者有短暂的积极效果但未持续，其余11名（41%）患者对这些药物无效果或有负面效果。本文讨论了这一新的意外发现的理论和实际意义。
