Fabian J E, Silverstone P H
Department of Psychiatry, University of Alberta Hospital, Edmonton, Canada.
Int Clin Psychopharmacol. 1997 Mar;12(2):113-20. doi: 10.1097/00004850-199703000-00007.
Calcium antagonists have previously been shown to be effective in the treatment of mania. In the present study we used dextroamphetamine administered to humans as a model of mania, to determine whether the calcium antagonist diltiazem would prevent dextroamphetamine-induced changes. This may help determine whether diltiazem is likely to be useful in the treatment of mania. Ten healthy volunteers were enrolled in this double-blind, placebo-controlled, balanced crossover study. Subjects received either oral diltiazem (60 mg) and placebo, placebo and dextroamphetamine (20 mg), diltiazem and dextroamphetamine, or placebo alone. Subjective and sleep changes were measured using visual analogue scales. Attentiveness and visual reaction times were measured repeatedly as were diastolic and systolic blood pressure. The results showed that dextroamphetamine alone produced a number of subjective changes, cardiovascular changes and changes in reaction time. Diltiazem significantly attenuated the cardiovascular changes, but not the subjective or reaction time changes. It is hypothesized that these findings may represent effects of diltiazem on noradrenergic neurotransmission. The results are tentatively supportive of suggestions that diltiazem may be clinically useful in the treatment of mania, as is another calcium channel antagonist, verapamil.
钙拮抗剂此前已被证明在治疗躁狂症方面有效。在本研究中，我们将给人类服用右旋苯丙胺作为躁狂症模型，以确定钙拮抗剂地尔硫䓬是否能预防右旋苯丙胺引起的变化。这可能有助于确定地尔硫䓬是否可能对治疗躁狂症有用。十名健康志愿者参与了这项双盲、安慰剂对照、平衡交叉研究。受试者分别接受口服地尔硫䓬（60毫克）和安慰剂、安慰剂和右旋苯丙胺（20毫克）、地尔硫䓬和右旋苯丙胺或仅接受安慰剂。使用视觉模拟量表测量主观和睡眠变化。反复测量注意力和视觉反应时间以及舒张压和收缩压。结果表明，单独使用右旋苯丙胺会产生一些主观变化、心血管变化和反应时间变化。地尔硫䓬显著减轻了心血管变化，但没有减轻主观或反应时间变化。据推测，这些发现可能代表了地尔硫䓬对去甲肾上腺素能神经传递的影响。这些结果初步支持了地尔硫䓬可能在临床上对治疗躁狂症有用的建议，另一种钙通道拮抗剂维拉帕米也是如此。
