– 1384 4 3 2 1* D 30 - 35 . . 44 . I of ive . (20 mg/kg/day) . (YMRS) (Remission) 12 ch . 23 YMRS . . : DSM IV (900 mg/day) ( Mixed ) (20 mg/kg/day) . (Response) Mann-Whitney Wilcoxon Fisher exact test Ar %50 (10-15 mg/day) . . SI . : YMRS SPSS Ver11 . p<0/05 21 27/18±7/34 44 : ( 17) %73/9 ( 18)%85/7 ( 10) %43/5 ( 9)%42/9 (p<0/05) . : I . : . 0311 2222135 : : 0913 3252576 -1 0311 2222135 : Email: [email protected] BMD(I) - -2 -3 -4 BMD(I) . (1 ) 84/7/13 : -1 2 3 4 84/5/20 : www.SID.ir 2 . (2 ) . ( ) . ( 6) DSMIV (YMRS) (11) 20 (3 ) ( 4) of . . ive . . . (6 ) II . Ar ch I . . SI . . D (10) . 900 ( 8) (9 ) mEq/L 10-15 20 . 1 . . 1384 – www.SID.ir 2 53 27/18±7/34 23 ( ) + . (1) ) . 21 . . . . D . %50 . SI .( p<0/05) (Response) (2) 12 . . CBC ( .(p<0/05) Mann-Whitney Wilcoxon, Fisher exact test Ar ch . 0/515 0/01 0/04 0/21 0/18 P 0/211 0/217 0/46 0/31 1384 p<0/05 :1 II ( ) SPSS11 (YMRS) P (Remission) . (YMRS) . 10 (YMRS) of + ) ive ( 44 ( I ) (47/8)11 (78/3)18 (21/7)5 (0)0 (0)0 ± 25/21±7/47 67/62±15/54 20/26±12/87 3/8±2/5 ( ) (38/1)8 (42/9)9 (42/9)9 (9/5)2 (4/8)1 ± 28/04±7/28 62/23±12/20 17/76±7/78 3/6±2/8 ( ( ) ) ( ( ) ) – www.SID.ir 2 :2 (YMRS) 2 1 + + ± ± 31/4±7/31 28/08±8/81 20/45±10/88 14/29±14/29 32/4±8/55 27/09±10/48 18/23±11/20 15/22±11/60 0/19 0/84 0/845 0/395 0/930 0/404 -2/39±5/12 -10/90±8/47 -17/88±6/53 -7/36±5/72 -12/82±5/85 -4/64±3/37 -5/33±4/48 -14/19±7/36 -17/33±9/61 -8/85±5/67 -12/61±8/08 -3/11±6/73 ) ( 1 + ) (66/7)14 (9/5)2 (4/8)1 (0)0 (4/8)1 (4/8)1 (0)0 (4/8)1 (0)0 (0)0 (4/8)1 (0)0 (0)0 ch ive (60/9)14 (0)0 (4/3)1 (4/3)1 (4/3)1 (0)0 (4/3)1 (4/3)1 (4/3)1 (4/3)1 (0)0 (4/3)1 (4/3)1 Ar 0/98 0/68 0/97 0/92 0/96 0/92 0/94 0/96 0/94 0/94 0/87 0/87 0/89 ( %43/5 %42/9 Remission (1) . . (3) %33/3 . %31/9 0/64±0/18mEq/L 0/49 ±0/10mEq/L %73/9 1384 ) :3 of 2 + P ( SI 0/69 0/73 0/51 0/80 D P %85/7 . – www.SID.ir 2 35 I :46 = 30 . : 46 %80 (13) (YMRS) 25 \f/?4/ s3 20 15 Sachs . (14) D 10 5 0/77 mEq/L 0 SI 1 . P 39: =/ 7 10 . :1 ive of . 2 (16 15) ch . . (Multicentric) Ar . I : . I . . (12) References 1384 – www.SID.ir www.SID.ir ive ch Ar of SI D 2 1. Sadock BJ, Sadock VA. Kaplan & Sadocks 10. First MB, Spitzer RL, Gibbon M, Structured comprehensive textbook of psychiatry. Lippincott Clinical Interview for DSM-IV New York, NY: Williams & Wilkins 2004; 1677. Biometric 2. Woods SW. The economic burden of bipolar disease. J Clin Psychiatry 2000; 61(Suppl 13): 38-41. New York State Psychiatric Institute; 1995. 11. Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity, and Curlos A, Zarate JR, Jore A. Quivoz. sensitivity. Br J Psychiatry 1978; 133: 429-435. Combination treatment in bipolar disorder: a 12. Zajecka JM, Weisler R, Sachs G. A comparison review of controlled trials. Bipolar disorders of the Efficacy, safety and tolerability of 2003; 5(3): 217-225. Divalproex Initial lithium and valproate combination therapy in acute mania. Neuropsychobiology 2002; 5. Reischeies FM,Harti Kanian J, Berghhofer AM. Intitial triple therapy of acute mania, adding 13. Kowatch RA, Sethuraman G, Hume JH, valproate to neuroleptics. Pharmacopschiatry 2002; 35(6): 244-6. Weinberg WA. Combination pharmacotherapy in children and adolescents with bipolar disorders. Biol Psychiaty 2003; 53(11): 978-84. of and 2002; 63(12): 1148-1155. Kromelis, 46(Suppl 1): 22-7. lithium treatment of Bipolar disorder. J Clin Psychiatry D 4. Reischeies FM, Hartikanian J, Berghofer A. sodium and olanzapine in the SI 3. Research, 14. Sachs G, Chengappa KN, Suppes T, Mullen JA, Brecher M, Devine NA, Sweitzer DE. A, Bowden CL. Combination of a mood Quetiapine with lithium or divalproex for the stabilizer with risperidon or haloperidol for treatment of bipolar mania: a randomized double- treatment of acute mania: a double-blind, blind, placebo-controlled study. Bipolar Disord placebo-controlled comparison of efficacy and 2004; 16(3): 213-23. ive 6. Sachs GS, Grossman F, Ghaemi SN, Okamato ch safety. Am J Psychiatry 2002; 159(7): 1146-54. 15. Melkersson KI, Hulting AL, Brismar KE. Elevated of insulin, leptin, and blood lipids in efficacy of atypical antipsychotics as add on olanzapine-treated patients with schizophrenia or therapy to mood stabilizers in the treatment of related psychoses. J Clin Psychiatry 2000; 61: Ar 7. Miller DS, Yathaqm LN, Lam RW. Comparative acute mania.J Clinical Psychiatry 2001;975-80. 8. Yatham LN. Efficacy s of atypical antipsychotics 742-749. 16. Osser DN, Najarian DM, Dufresne RL. in mood disorders. J Clin Psychopharmacol Olanzapine 2003; 23(3 Suppl 1): 9-14. triglyceride levels. J Clin Psychiatry 1999; 60: 9. Ghaemi SN. New treatment for bipolar disorder; increases weight and serum 767-770. the role of atypical neuroleptic agents. J Clin psychiatry 2000; 61(suppl 14): 33-42. 1384 – www.SID.ir
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