Lithium, carbamazepine and valproate in acute mania
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Dosyalar
Tarih
2001
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Klinik Psikofarmakoloji Bülteni
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Öz: Amaç: Duygudurum düzenleyicileri akut mani tedavisinin vazgeçilmez ilaçlarıdır. Lityum psikotik eksitasyonda etkili olduğu, 1949 yılında Cade tarafından bildirildiğinden beri kullanılmaktadır. Karbamazepin ve valproat da lityumun alternatifleri olarak görülmektedirler. Bu ilaçlardan hangisinin akut manide daha etkili olduğu henüz yanıtı tam olarak verilemeyen bir soru olarak klinisyenleri meşgul etmektedir. Bu açık çalışma akut manili has-talarda lityum, karbamazepin ve valproatın etkinliğini ve etkinin ortaya çıkma süresini karşılaştırmak için yapılmıştır. Yöntem: Çalışmaya tanıları DSM-IV sınıflandırmasına göre konulmuş, akut manili, yatan 30 hasta alınmıştır. Her bir grupta 10 hasta yer almış, altı hafta izlenen hastalara haftalık olarak Bech-Rafaelsen Mani Ölçeği, Kısa Psikiyatrik Değerlendirme Ölçeği, Klinik Global izlenim Ölçeği uygulanmış ve ilaçların kan düzeyleri ölçülmüştür. Sadece zorunlu oldukça kullanılan nöroleptikler klorpromazin eşdeğeri olarak kaydedilmişlerdir. Bulgular: Üç ilacın etkinliği ve etki hızı benzer bulunmuştur. Her üç grupta da klinik iyileşme üçüncü haftada başlamış, çalışma boyunca kullanılan nöroleptiklerin miktarı istatistiksel açıdan anlamlı bir farklılık göstermemiş ve altı haftalık çalışma tamamlandığında hastalardaki iyileşme benzer bulunmuştur. Sonuçlar: Lityum, karbamazepin ve valproat akut maninin tedavisinde etkili ilaçlardır. Çalışmamızda bu ilaçların hiçbirisi, diğer ikisinden daha üstün bulunmamıştır.
Abstract: Objective: Mood stabilizers are frequently used in the manage-ment of acute mania. Lithium has been used for this indication since Cade first described its effectiveness in psychotic excitation in 1949. Carbamazepine and valproate are also accepted as effective antimanic agents. Whether öne of these agents is more effective than others is stili a matter of discussion. Our aims have been to clarify this issue and to see which öne has a faster onset of action. Methods: We compared the clinical efficacy of lithium, Carbamazepine and valproate in 30 inpatients with acute mania. Diagnoses were made according to DSM-IV criteria. There were 10 patients on each arm. Clinical efficacy was assessed vveekly by Bech-Rafaelsen Mania Scale, Brief Psychiatric Rating Scale, and Clinical Global Impressions Scale for six vveeks. Serum levels of study drugs were obtained vveekly in orderto maintain recommended serum levels. We referred to neuroleptics for excitation when really necessary, and the amount used was recorded as chlorpromazine eguivalents. Results: During weekly assessments and at the end of the study, none of the drugs was superior to each other neither in antimanic efficacy nor in the week the efficacy began at, AH of study drugs reduced assessment scale scores significantly at the end of third week. The amount of neuroleptics used was not different among the patient groups. Conciusions: Lithium, Carbamazepine and valproate are efficacious antimanic agents that have no superiority on each other in treatment of acute mania, but these findings need to be replicated in larger studies.
Abstract: Objective: Mood stabilizers are frequently used in the manage-ment of acute mania. Lithium has been used for this indication since Cade first described its effectiveness in psychotic excitation in 1949. Carbamazepine and valproate are also accepted as effective antimanic agents. Whether öne of these agents is more effective than others is stili a matter of discussion. Our aims have been to clarify this issue and to see which öne has a faster onset of action. Methods: We compared the clinical efficacy of lithium, Carbamazepine and valproate in 30 inpatients with acute mania. Diagnoses were made according to DSM-IV criteria. There were 10 patients on each arm. Clinical efficacy was assessed vveekly by Bech-Rafaelsen Mania Scale, Brief Psychiatric Rating Scale, and Clinical Global Impressions Scale for six vveeks. Serum levels of study drugs were obtained vveekly in orderto maintain recommended serum levels. We referred to neuroleptics for excitation when really necessary, and the amount used was recorded as chlorpromazine eguivalents. Results: During weekly assessments and at the end of the study, none of the drugs was superior to each other neither in antimanic efficacy nor in the week the efficacy began at, AH of study drugs reduced assessment scale scores significantly at the end of third week. The amount of neuroleptics used was not different among the patient groups. Conciusions: Lithium, Carbamazepine and valproate are efficacious antimanic agents that have no superiority on each other in treatment of acute mania, but these findings need to be replicated in larger studies.
Açıklama
Yıl: 2001Cilt: 11Sayı: 2ISSN: 1017-7833 / 1302-9657Sayfa Aralığı: 90 - 95Metin Dili:İngilizce
Anahtar Kelimeler
Kaynak
Klinik Psikofarmakoloji Bülteni
WoS Q Değeri
Scopus Q Değeri
N/A
Cilt
11
Sayı
2
Künye
ÖZCAN M. E,BOZTEPE A. V (2001). Lithium, carbamazepine and valproate in acute mania. Klinik Psikofarmakoloji Bülteni, 11(2), 90 - 95.
