Kaplan G B
Brown University, Providence, Rhode Island.
R I Med. 1992 May;75(5):247-51.
The limbic system, temporal cortex and the locus coeruleus are important brain regions in the neuroanatomy of panic states. There is evidence for beta- and alpha 2-adrenoreceptor abnormalities and pre- and post-synaptic serotonergic alterations in panic disorder subjects. The anti-panic effects of chronic antidepressant drug treatment may relate to their down-regulation of various components of noradrenergic function and overall enhancement of serotonergic function. The efficacy of benzodiazepine agents in panic disorder and the altered sensitivity of panic patients to benzodiazepine agonists and inverse agonists suggest that alterations in benzodiazepine/GABA receptors may have a role in this disorder. A variety of other pharmacological agents also provoke panic, demonstrating that the biological origins of this disorder are quite diverse and complicated. Most importantly, a variety of new agents that selectively affect different components of these neurotransmitter/receptor systems are being developed. These novel agents offer future promise of greater efficacy with less adverse effects for individuals with panic disorder.
边缘系统、颞叶皮质和蓝斑是惊恐状态神经解剖学中的重要脑区。有证据表明惊恐障碍患者存在β-和α2-肾上腺素能受体异常以及突触前和突触后血清素能改变。慢性抗抑郁药物治疗的抗惊恐作用可能与其下调去甲肾上腺素能功能的各个成分以及整体增强血清素能功能有关。苯二氮䓬类药物在惊恐障碍中的疗效以及惊恐患者对苯二氮䓬类激动剂和反向激动剂的敏感性改变表明，苯二氮䓬/GABA受体的改变可能在该疾病中起作用。多种其他药理剂也会引发惊恐，这表明该疾病的生物学起源非常多样和复杂。最重要的是，正在开发多种选择性影响这些神经递质/受体系统不同成分的新型药物。这些新型药物为惊恐障碍患者带来了未来疗效更高、副作用更小的希望。
