摘要:

Carbamazepine and valproic acid are anticonvulsants with mood-stabilizing properties. Basic and clinical research suggest that these medications used together may have synergistic anticonvulsant effects. Psychotropic synergy of the combination has yet to be explored systematically. We present the case of a patient with rapid-cycling bipolar disorder studied under double-blind conditions whose hypomanias and depressions were refractory to either carbamazepine or valproic acid alone, but responded dramatically to the combination. The superior response to the combination appeared to be due to pharmacodynamic rather than pharmacokinetic effects. The clinical and theoretical aspects of the use of carbamazepine and valproic acid in combination are discussed.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Adinazolam is a triazolobenzodiazepine with anxiolytic and antidepressant activity. Adinazolam is metabolized extensively; the major metabolite,N-desmethyladinazolam (NDMAD), possesses significant pharmacologic activity. NDMAD is eliminated predominantly by renal excretion. Ranitidine, a histamine H2-receptor antagonist, is also excreted renally and may compete with NDMAD for renal secretion. The purpose of this study was to examine the effect of ranitidine on the pharmacokinetics and pharmacodynamics of adinazolam and NDMAD. In a randomized, crossover study, 12 healthy male volunteers received 300 mg of ranitidine orally followed by 30 mg of adinazolam 1 hour later (treatment A), or adinazolam alone (treatment B). Pharmacodynamic alterations were assessed using card sorting, digit-symbol substitution, and short-term memory tests. Venous blood samples were obtained over 24 hours for analysis of adinazolam and NDMAD by high-performance liquid chromatography. Urine samples also were collected and analyzed for NDMAD. No significant difference in adinazolam oral clearance (1,149 vs. 1,135 ml/hr/kg) was noted between treatments (A vs. B, respectively). Furthermore, the renal clearance of NDMAD (196 vs. 198 ml/min) and the cumulative urinary excretion of NDMAD (% dose; 61.2 vs. 62.3) were not significantly different. Repeated-measures analysis of variance indicated no significant differences in psychomotor performance or short-term memory between treatments. Results suggest that ranitidine has no effect on adinazolam disposition, NDMAD renal clearance, or the central nervous system effects mediated by the drug.

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1992

数据来源: OVID