Krüger S, Bräunig P, Young L T
Westfälisches Zentrum für Psychiatrie, Univeristy of Bochum, Germany.
Pharmacopsychiatry. 1996 Sep;29(5):167-75. doi: 10.1055/s-2007-979566.
Rapid-cycling bipolar disorder (RCBD) is currently defined as the presence of at least four affective episodes per year. RCBD is often difficult to treat with standard therapies bipolar disorder (BD), thus dictating special treatment strategies. This is especially true for the treatment of RCBD with lithium, which has been described as insufficient to prevent the high-frequency episodes in up to 82% of cases. There are several other possibilities for the biological treatment of RCBD, including the mood-stabilizers carbamazepine (CBZ) and valproate, neuroleptics, antidepressants, calcium channel blockers, l-thyroxine, benzodiazepines. ECT, total sleep deprivation and several other less proven agents. The utility of these agents and treatment procedures in the acute and prophylactic treatment of RCBD is reviewed. Special emphasis is placed on the controversial discussion of the possible induction and worsening of RCBD by antidepressant treatment. Finally, a number of guidelines for the pharmacological management of RCBD are proposed.
快速循环型双相情感障碍（RCBD）目前被定义为每年至少出现四次情感发作。RCBD通常难以用双相情感障碍（BD）的标准疗法进行治疗，因此需要特殊的治疗策略。在用锂治疗RCBD时尤其如此，据描述，锂在高达82%的病例中不足以预防高频发作。RCBD的生物治疗还有其他几种可能性，包括心境稳定剂卡马西平（CBZ）和丙戊酸盐、抗精神病药、抗抑郁药、钙通道阻滞剂、左甲状腺素、苯二氮䓬类药物。电休克治疗、完全睡眠剥夺以及其他一些未经充分验证的药物。本文综述了这些药物和治疗方法在RCBD急性和预防性治疗中的效用。特别强调了关于抗抑郁药治疗可能诱发和加重RCBD的争议性讨论。最后，提出了一些RCBD药物治疗管理的指南。
