Quattrocki E, Baird A, Yurgelun-Todd D
Consolidated Department of Psychiatry, Harvard Medical School, Boston, Mass. (Drs. Quattrocki and Yurgelun-Todd).
Harv Rev Psychiatry. 2000 Sep;8(3):99-110.
A link between smoking and depressive symptoms has been described in the literature for over a decade. The neurotransmitter systems affected by cigarette smoke mirror the neurotransmitter pathways thought to be involved in the biological mechanisms of depression. Cigarette smoke contains several psychoactive chemicals; nicotine is the best studied among these and is widely accepted to be the addictive substance in tobacco. Nicotine binds to nicotinic receptors in the brain, augmenting the release of numerous neurotransmitters, including dopamine, serotonin, norepinephrine, acetylcholine, gamma-aminobutyric acid, and glutamate. Cigarette smoke has other psychoactive properties apart from nicotinic receptor stimulation. For example, it inhibits monoamine oxidase (the enzyme responsible for breaking down the biogenic amine neurotransmitters norepinephrine, serotonin, and dopamine) in the brain. Various antidepressants act through modulation of the biogenic amine neurotransmitter pathways. That the neural substrates modified by both smoking and antidepressant drugs overlap has relevance to smoking cessation. The use of antidepressants as adjuvants to smoking-cessation treatment can enhance cessation success rates. Understanding the neurobiological mechanisms underlying the association between smoking and depression may improve physicians' ability to assist smokers in their efforts to quit and will contribute to a more thorough comprehension of both the biology of addiction and the etiology of depression.
吸烟与抑郁症状之间的联系在文献中已有十多年的描述。受香烟烟雾影响的神经递质系统反映了被认为参与抑郁症生物学机制的神经递质途径。香烟烟雾含有多种具有精神活性的化学物质；尼古丁是其中研究得最为充分的，并且被广泛认为是烟草中的成瘾物质。尼古丁与大脑中的烟碱受体结合，增加包括多巴胺、血清素、去甲肾上腺素、乙酰胆碱、γ-氨基丁酸和谷氨酸在内的多种神经递质的释放。除了刺激烟碱受体外，香烟烟雾还具有其他精神活性特性。例如，它会抑制大脑中的单胺氧化酶（负责分解生物胺神经递质去甲肾上腺素、血清素和多巴胺的酶）。各种抗抑郁药通过调节生物胺神经递质途径起作用。吸烟和抗抑郁药所改变的神经底物存在重叠，这与戒烟有关。使用抗抑郁药作为戒烟治疗的辅助手段可以提高戒烟成功率。了解吸烟与抑郁之间关联背后的神经生物学机制，可能会提高医生帮助吸烟者戒烟的能力，并有助于更全面地理解成瘾生物学和抑郁症的病因。
