Ohno Y
Discovery Laboratory I, Sumitomo Pharmaceuticals Co., Ltd., Osaka, Japan.
Nihon Yakurigaku Zasshi. 2000 Oct;116(4):225-31. doi: 10.1254/fpj.116.225.
It is now known that the blockade of 5-HT2 receptors can ameliorate the negative symptoms of schizophrenia and extrapyramidal side effects (EPS) associated with antipsychotic treatments. Perospirone hydrochloride (perospirone), which was identified as a novel serotonin-dopamine antagonist (SDA)-type antipsychotic agent in 1987 by Sumitomo Pharmaceuticals, possesses high affinities both for dopamine 5-HT2 and D2 receptors. Perospirone, like conventional antipsychotics, significantly inhibited various behaviors induced by dopaminergic hyperactivation. Perospirone also produced a significant improvement in animal models of the negative symptoms and mood disorders, where the conventional antipsychotics were unaffected. In addition, perospirone was weaker than the conventional antipsychotics (e.g., haloperidol) in inducing EPS signs (e.g., catalepsy and bradykinesia), suggesting that the drug has an atypical antipsychotic property. A recent double-blind study with schizophrenia patients demonstrated that perospirone was comparative with haloperidol in improving the positive symptoms, but was significantly superior to haloperidol against the negative symptoms. Furthermore, the extrapyramidal score in patients with perospirone treatment was lower that those with haloperidol treatment. These findings suggested that perospirone acts as an antagonist both for 5-HT2 and D2 receptors and has broader clinical efficacy and lower EPS liability than haloperidol in schizophrenia treatment.
现已知道,5-羟色胺2(5-HT2)受体阻断可改善精神分裂症的阴性症状以及与抗精神病药物治疗相关的锥体外系副作用(EPS)。盐酸哌罗匹隆(perospirone)由住友制药公司于1987年鉴定为新型5-羟色胺-多巴胺拮抗剂(SDA)类抗精神病药物,对5-HT2和多巴胺D2受体均具有高亲和力。与传统抗精神病药物一样,哌罗匹隆可显著抑制多巴胺能亢进诱导的各种行为。在传统抗精神病药物无作用的阴性症状和心境障碍动物模型中,哌罗匹隆也产生了显著改善。此外,在诱导EPS体征(如僵住症和运动迟缓)方面,哌罗匹隆比传统抗精神病药物(如氟哌啶醇)作用弱,提示该药具有非典型抗精神病特性。最近一项针对精神分裂症患者的双盲研究表明,在改善阳性症状方面,哌罗匹隆与氟哌啶醇相当,但在改善阴性症状方面显著优于氟哌啶醇。此外,接受哌罗匹隆治疗患者的锥体外系评分低于接受氟哌啶醇治疗的患者。这些发现提示,哌罗匹隆作为5-HT2和D2受体的拮抗剂,在精神分裂症治疗中比氟哌啶醇具有更广泛的临床疗效和更低的EPS倾向。