Hurowitz G I, Liebowitz M R
Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York.
J Clin Psychopharmacol. 1993 Feb;13(1):52-6.
We report six cases of rapid mood cycling induced by antidepressant treatment. The key to effective treatment involved the recognition of the pattern of apparent remission, relapse, antidepressant and/or stimulant adjustment, remission, relapse, etc. Hypomanic episodes were frequently mild and could be mistaken for remission. The destabilizing effects of antidepressant drugs were not corrected by the addition of mood stabilizers, necessitating the withdrawal of the antidepressant agent. All but one case responded to such withdrawal. Two cases required the addition of high-dose L-thyroxine for stabilization. Implications for an effective treatment protocol are discussed.
我们报告了6例由抗抑郁治疗引起的快速心境循环病例。有效治疗的关键在于识别明显缓解、复发、抗抑郁药和/或兴奋剂调整、缓解、复发等模式。轻躁狂发作通常较轻，可能被误认为是缓解。添加心境稳定剂并不能纠正抗抑郁药的 destabilizing 作用，因此需要停用抗抑郁药。除1例病例外，所有病例对这种停药均有反应。2例病例需要添加高剂量左甲状腺素以实现病情稳定。文中讨论了有效治疗方案的意义。 （注：“destabilizing”直译为“破坏稳定的”，结合语境这里可能是指抗抑郁药产生的不良影响导致病情不稳定，但具体含义需结合更多医学背景知识确定）
