Donovan S J, Nunes E V
Depression Evaluation Service, New York State Psychiatric Institute, NY 10032, USA.
Am J Addict. 1998 Summer;7(3):210-20.
The authors examine the use of anticonvulsants/mood stabilizers to treat patients with substance use disorders. Although there is high comorbidity of bipolar and substance use disorders, there has been little research on the use of these medications to treat bipolar disorders in patients who also have a substance use disorders. However, symptoms of bipolar disorders, such as irritability and mood lability, may be difficult to distinguish from the effects of acute and chronic substance use; therefore, reliable diagnostic methods will need to be developed. Further, a new, hypothesized syndrome, Explosive Mood Disorder, is described that may be distinct from the bipolar spectrum. It is characterized by childhood onset of temper outbursts and irritable mood that persists into adolescence and adulthood, is connected to marijuana use, and responds to divalproex sodium. The authors review studies of prevalence, comorbidity, family history, longitudinal course, and placebo-controlled trials of anticonvulsant medications to evaluate the validity and treatment implications of this proposed entity.
作者们研究了使用抗惊厥药/心境稳定剂治疗物质使用障碍患者的情况。尽管双相情感障碍和物质使用障碍的共病率很高，但对于在患有物质使用障碍的患者中使用这些药物治疗双相情感障碍的研究却很少。然而，双相情感障碍的症状，如易怒和情绪不稳定，可能难以与急性和慢性物质使用的影响区分开来；因此，需要开发可靠的诊断方法。此外，还描述了一种新的、假设的综合征——爆发性心境障碍，它可能与双相谱系不同。其特征是童年期出现发脾气和易怒情绪，并持续到青少年期和成年期，与大麻使用有关，且对丙戊酸钠有反应。作者们回顾了关于抗惊厥药物的患病率、共病情况、家族史、纵向病程以及安慰剂对照试验的研究，以评估这一拟议实体的有效性和治疗意义。
