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首页> 外文期刊>The journal of clinical psychiatry >Effect of Lamotrigine on Cognitive Complaints in Patients With Bipolar I Disorder.
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Effect of Lamotrigine on Cognitive Complaints in Patients With Bipolar I Disorder.

机译：拉莫三嗪对I型双相情感障碍患者认知投诉的影响。

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BACKGROUND: This analysis describes the effects of bipolar I disorder on self-reported neurocognitive measures and remediation of these deficits with lamotrigine therapy. METHOD: Data were derived from 2 clinical trials designed to assess the efficacy of lamotrigine as maintenance therapy for recently manic (N = 349) or depressed (N = 966) patients (DSM-IV criteria). During the 8- to 16-week open stabilization phase, patients received lamotrigine as monotherapy or as adjunctive therapy (target dose = 200 mg/day, minimum dose = 100 mg/day) while other psychotropic drugs were discontinued. The Medical Outcomes Study Cognitive Scale (MOS-Cog) and the AB-Neurological Assessment Scale (AB-NAS) were used to measure cognitive functioning at baseline and at the end of the open-label phase. To examine the relationship between depressive and manic symptomatology, initiation of lamotrigine, and cognitive functioning, correlational analyses and analyses of covariance were conducted. RESULTS: Bipolar patients in both trials had significant cognitive impairment; however, it was much greater in index episode depressed bipolar patients compared with index episode manic patients. In both studies, substitution of lamotrigine for other psychotropic medications significantly improved the mean scores from baseline to the end of the open-label phase on the MOS-Cog and the AB-NAS (p < .0001). Among patients who took lamotrigine as monotherapy, the mean MOS-Cog score also improved significantly versus baseline (+32.2, or 81%, for depressed patients, p < .0001; and +19.9, or 35%, for manic patients, p < .0001). Mean AB-NAS scores (-19.7, or -55%, for depressed patients, p < .0001; and -7.2, or -32%, for manic patients, p = .0062) showed similar improvement. Cognitive impairment was significantly correlated with depression symptom severity based on Hamilton Rating Scale for Depression scores (p < .0001). After controlling for change in mood, age, gender, baseline score, duration of illness, and duration of use of other psychotropics, a significant improvement in cognition was observed during the open-label phase when lamotrigine was used as monotherapy/adjunctive therapy. CONCLUSION: Treatment with lamotrigine as monotherapy and as adjunctive therapy was associated with improved cognitive functioning and reduced neurocognitive side effects, regardless of index mood polarity.
机译：背景：这项分析描述了躁郁症对自我报告的神经认知措施的影响以及拉莫三嗪疗法对这些缺陷的修复。方法：数据来自两项旨在评估拉莫三嗪作为维持疗法对近期躁狂（N = 349）或抑郁（N = 966）患者（DSM-IV标准）的疗效的临床试验。在8至16周的开放稳定期中，患者接受拉莫三嗪单药治疗或辅助治疗（目标剂量= 200 mg /天，最小剂量= 100 mg /天），而其他精神药物停用。医学成果研究认知量表（MOS-Cog）和AB神经病学评估量表（AB-NAS）用于测量基线和开放标签阶段结束时的认知功能。为了检查抑郁症和躁狂症状，拉莫三嗪的起始和认知功能之间的关系，进行了相关分析和协方差分析。结果：两项试验中的双相情感障碍患者都有明显的认知障碍。然而，与抑郁发作指数躁狂患者相比，抑郁发作指数躁郁症患者的患病率更高。在这两项研究中，用拉莫三嗪替代其他精神药物可显着提高MOS-Cog和AB-NAS从基线到开放标签阶段结束的平均得分（p <.0001）。在接受拉莫三嗪单药治疗的患者中，平均MOS-Cog评分也较基线水平显着提高（抑郁症患者为+32.2或81％，p <.0001;躁狂患者为+19.9，或35％，p < .0001）。 AB-NAS平均得分（抑郁症患者为-19.7，或-55％，p <.0001;躁狂患者为-7.2，或-32％，p = .0062）也显示出类似的改善。根据汉密尔顿抑郁量表评分表，认知障碍与抑郁症状严重程度显着相关（p <.0001）。在控制了情绪，年龄，性别，基线评分，疾病持续时间和使用其他精神药物的持续时间的变化之后，在开放标签阶段将拉莫三嗪用作单一疗法/辅助疗法时，认知能力得到了显着改善。结论：拉莫三嗪作为单一疗法和辅助疗法的治疗与改善的认知功能和减少的神经认知副作用有关，而与指数情绪极性无关。

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