BJPsych：氟西汀、碳酸锂治疗循环型双相情感障碍的复发率相似

　　《英国精神病学杂志》四月刊登的一项随机双盲安慰剂对照试验的结果显示，碳酸锂、氟西汀单一疗法与安慰剂，在快速及非快速循环型双相情感障碍的长期及复发预防治疗中，受试者的抑郁复发率及治疗诱发的情绪转变发生率相似。

　　医学界对应用抗抑郁药物治疗快速循环型双相情感障碍一直存在争议。此研究评价了使用氟西汀或碳酸锂单一疗法，对快速循环型双相情感障碍或非快速循环型双相情感障碍患者进行个体化治疗的安全性及有效性。

　　此研究选取初期接受氟西汀单一疗法效果稳定的病人，对氟西汀，碳酸锂单一疗法进行随机双盲安慰剂对照试验。快速循环组与非快速循环组相比，抑郁复发的参与者占该组总人数的比例相似（P=0.20），两组的复发几率（P=0.36）、复发风险（风险比0.87, 95%CI 0.40-1.91）相似。两组受试者躁狂评级的分数改变相似（P=0.86）。两组受试者综合征（P=0.27）或亚综合症性（P=0.82—）轻躁狂的发生率没有区别。

与情感障碍相关的拓展阅读： 

• BMC MED：磺脲类和二甲双胍联用或降2型糖尿病患者情感障碍风险 更多信息请点击：有关情感障碍更多资讯

Efficacy and mood conversion rate during long-term fluoxetine v. lithium monotherapy in rapid- and non-rapid-cycling bipolar II disorder
Background
Controversy exists over antidepressant use in rapid-cycling bipolar disorder.
Aims
Exploratory analysis of safety and efficacy of fluoxetine v. lithium monotherapy in individuals with rapid- v. non-rapid-cycling bipolar II disorder.
Method
Randomised, double-blind, placebo-controlled comparison of fluoxetine v. lithium monotherapy in patients initially stabilised on fluoxetine monotherapy (trial registration NCT00044616).
Results
The proportion of participants with depressive relapse was similar between the rapid- and non-rapid-cycling groups (P = 0.20). The odds of relapse were similar between groups (P = 0.36). The hazard of relapse was similar between groups (hazard ratio 0.87, 95% CI 0.40–1.91). Change in mania rating scores was similar between groups (P = 0.86). There was no difference between groups in the rate of syndromal (P = 0.27) or subsyndromal (P = 0.82) hypomania.
Conclusions
Depressive relapse and treatment-emergent mood conversion episode rates were similar for lithium and fluoxetine monotherapy and placebo during long-term, relapse-prevention therapy of rapid- and non-rapid-cycling bipolar II disorder.