[Comparative effectiveness of preventive use of lithium carbonate, carbamazepine and sodium valproate in affective and schizoaffective psychoses]

Abstract

To specify differentiated indications for preventive use of normothymic drugs, a prospective study was made of 3 groups of patients with phasic endogenous psychoses, comparable as regards the main ++clinico-anamnestic characteristics. The patients had been administered lithium carbonate (LC, 30 persons), carbamazepine (CRB, 30 patients), and sodium valproate (SV, 28 patients) for no less than one year. It was discovered that all the drugs exhibited marked preventive action to an equal degree. The mean annual magnitude of the total duration of the affective symptomatology reduced by 49.3% in LC administration, by 55.9% in CRB, and by 45.6% in SV administration; the rate of episodes decreased by 53.8, 57.5 and 52.2%, respectively. The anticonvulsants produced a stable preventive effect more rapidly (within the first 2-3 months of the treatment) as compared to LC. CRB had a more pronounced preventive efficacy in atypical affective and schizoaffective psychoses as well as in depressions, particularly in those with predominance of anxiety. As for its activity profile, SV approximated LC and was more effective in psychic endogenomorphous variants of MDP with a typical circadian vital symptom-complex. Unlike LC, the anticonvulsants demonstrated a well-defined capacity to interrupt the continual course of circulatory disorders including the "rapid cyclicity" phenomenon.