関連する実験動画
リチウムとバルプロアートの併用療法と,双極性障害I型における再発予防のための単独療法 (BALANCE):ランダム化オープンラベル試験
1, John R Geddes, Guy M Goodwin
1Oxford Clinical Trials Unit for Mental Illness, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK. john.geddes@psych.ox.ac.uk
Lancet (London, England)
|January 23, 2010
まとめ
リチウムとバルプロアートとの併用療法,およびリチウム単独は,バイポラーI型障害の再発を予防するためにバルプロアート単独よりも効果的です. この発見は,気分エピソードを経験している患者のための改善された治療オプションを提供します.
科学分野:
- 精神科医は精神病を患っている.
- 薬理学 薬理学とは
- クリニック・トライアル 臨床試験
背景:
- 双極性1型障害の再発は,障害の重要な原因である.
- リチウム炭酸とバルプロ酸セミナトリウムは,推奨される単一療法ですが,しばしば完全な有効性が欠如しています.
- 併用療法により,再発の予防が改善される可能性があります.
研究 の 目的:
- リチウムとバルプロアートの併用療法と,双極性I型障害の再発を防ぐために,いずれかの薬剤による単独治療に対するリチウムとバルプロアートの併用療法の有効性を比較するために.
- リチウムまたはバルプロアート単独療法と比較して,併用療法がより優れた再発予防を提供するかどうかを評価する.
主な方法:
- ランダム化され,オープンラベル試験で,双極性I型障害の患者330人が参加した.
- 参加者はリチウム単独治療,バルプロアート単独治療,または両者の組み合わせを受けた.
- 最大24ヶ月のフォローアップで,主なアウトカムとなるのは,突然の気分エピソードに対する新しい介入の開始である.
主要な成果:
- 併用療法 (54%) とリチウム単独療法 (59%) は,バルプロアート単独療法 (69%) と比較して,プライマリアウトカムイベントの割合が低いことを示しました.
- 併用療法がバルプロアート単独療法より有意に優れていた (HR 0.59,p=0.0023).
- リチウム単独療法もバルプロアート単独療法より有意に優れていた (HR 0.71,p=0.0472).
結論:
- リチウムとバルプロアートの併用療法とリチウム単独治療は,バルプロアートの単独治療よりも,双極性I型障害の再発を予防する上でより効果的です.
- これらの治療の効果は最大2年間持続し,発症時の重症度とは無関係です.
- この研究は,リチウム単独療法に対する組み合わせ治療の利点を決定的に確認または反証することができなかった.
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