情绪稳定剂和苯二氮[艹卓]类药对无抽搐电休克治疗诱导癫痫发作的影响

Effects of mood stabilizers and benzodiazepines on modified electroconvulsive therapy-induced seizures

目的:探讨情绪稳定剂(MSs)和苯二氮[艹卓]类药(BZs)对无抽搐电休克治疗(MECT)诱导癫痫发作阈值、刺激电量和癫痫发作持续时间的影响。方法:347例接受MECT治疗的精神障碍患者根据用药情况分为MSs组(79例)、BZs组(87例)、合用组(118例)和对照组(63例),采用MECT从低剂量开始滴定刺激电量。记录阈值电量、每次治疗电量和癫痫发作持续时间,并进行组间比较。结果:各组MECT阈值电量、平均刺激电量及诱导的癫痫发作持续时间比较差异有统计学意义(P均<0.01);各组阈值电量依次为合用组>MSs组>BZs组>对照组;平均刺激电量依次为合用组>MSs组>BZs组>对照组;诱导癫痫发作持续时间依次为对照组>BZs组>MSs组>合用组。结论:服用MSs或BZs的精神障碍患者进行MECT治疗时出现癫痫发作时间缩短和刺激电量增加;其中服用MSs对其的影响大于BZs;MSs和BZs合用时对此影响更大。

Objective:To investigate the effects of mood stabilizers(MSs)and benzodiazepines(BZs)on modified electroconvulsive therapy(MECT)-induced seizures'threshold,stimulated power and induced seizure duration.Method:347 mental disorder patients treated with MECT were divided into mood stabilizers group(MSs group,n=79),benzodiazepines group(BZs group,n=87),combined group(n=118)and control group(n=63)and MECT therapy was used to titrate the stimulated power from low dose.Threshold power,each stimulated power and induced seizure duration were recorded and the differences of seizure indexes above-mentioned were compared.Results:There were statistically significant differences in MECT threshold,average stimulated power and induced seizure duration in each group(all P<0.01).The order of threshold power from large to small was combined group>MSs group>BZs group>control group.The average stimulated power from high to low ranked as combined group>MSs group>BZs group>control group,and the induced seizure duration from long to short was control group>BZs group>MSs group>combined group.Conclusion:In patients with mental disorders who take MSs or BZs during MECT treatment,the seizure time is shortened and the stimulation power is increased.MSs has a greater effect than BZs,and the effect is more serious when they are combined.