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首页> 外文期刊>The journal of clinical psychiatry >Treatment of Posttraumatic Stress Disorder With Phenytoin: An Open-Label Pilot Study.
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Treatment of Posttraumatic Stress Disorder With Phenytoin: An Open-Label Pilot Study.

机译：苯妥英钠治疗创伤后应激障碍的开放性试验研究。

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BACKGROUND: Phenytoin is an anticonvulsant used in the treatment of epilepsy. Its mechanism of action is incompletely understood but most likely involves modulation of glutamatergic transmission. The neurobiology of posttraumatic stress disorder (PTSD) has been hypothesized to involve, at least in part, alterations in glutamatergic transmission in the hippocampus and possibly other brain regions. The purpose of this study was to assess the effects of phenytoin on symptoms of PTSD. METHOD: Phenytoin was administered in an open-label fashion for 3 months to 9 adult male and female patients with DSM-IV PTSD related to a variety of traumas including childhood abuse, combat, and car accidents. Dosage was adjusted to maintain the therapeutic blood levels used in the treatment of epilepsy. Subjects were assessed before, during, and after treatment for PTSD with standardized dimensional measures of disease severity including the Clinician Administered PTSD Scale (CAPS), the Hamilton Rating Scale for Depression(HAM-D), and the Hamilton Rating Scale for Anxiety (HAM-A). Data were collected from November 2001 through June 2003. RESULTS: Phenytoin treatment resulted in a significant decrease in PTSD symptoms as measured with the CAPS (mean score = 65 pretreatment vs. 38 posttreatment) with reductions in each of the symptom clusters of intrusions, avoidance, and hyperarousal (p < .05). There were no significant decreases in symptoms of depression severity as measured with the HAM-D or anxiety severity as measured with the HAM-A. CONCLUSIONS: These findings suggest that phenytoin may be efficacious in the treatment of PTSD, possibly mediated through its antiglutamatergic effects. Randomized, controlled, double-blind clinical trials are indicated to further evaluate this medication in the treatment of PTSD.
机译：背景：苯妥英钠是一种抗惊厥药，用于治疗癫痫。其作用机理尚不完全清楚，但很可能涉及调节谷氨酸能传递。创伤后应激障碍（PTSD）的神经生物学被认为至少部分涉及海马和其他大脑区域的谷氨酸能传递的改变。这项研究的目的是评估苯妥英钠对PTSD症状的影响。方法：对9名患有DSM-IV PTSD的成年男性和女性患者，以开放标签的方式给予苯妥英3个月，这些患者与各种创伤有关，包括童年虐待，战斗和交通事故。调整剂量以维持用于治疗癫痫的治疗性血液水平。对受试者进行PTSD治疗之前，期间和之后的评估，采用疾病严重程度的标准尺寸测量方法，包括临床医生管理的PTSD量表（CAPS），汉密尔顿抑郁量表（HAM-D）和汉密尔顿焦虑量表（HAM） -一种）。从2001年11月至2003年6月收集了数据。结果：苯丙氨酸治疗导致CAPSD的PTSD症状显着减少（平均得分=治疗前65分，治疗后38分），侵入性症状簇的减少，避免，以及过度兴奋（p <.05）。用HAM-D测得的抑郁严重程度症状无明显减轻，而用HAM-A测得的焦虑严重程度则无明显减轻。结论：这些发现表明苯妥英钠对PTSD的治疗可能是有效的，可能是通过其抗谷氨酸能作用介导的。指示随机，对照，双盲临床试验可进一步评估该药物在PTSD治疗中的作用。

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