Hirota Shiho, Kawashima Naoya, Chaki Shigeyuki, Okuyama Shigeru
Psychiatric Diseases and Pain Research, Medicinal Pharmacology Laboratory, Medicinal Research Laboratories, Taisho Pharmaceutical Co., Ltd., 1-403 Yoshino-cho, Kita-ku, Saitama, Saitama 331-9530, Japan.
CNS Drug Rev. 2003 Winter;9(4):375-88. doi: 10.1111/j.1527-3458.2003.tb00261.x.
Schizophrenia is a serious and disabling psychiatric disorder affecting approximately 1% of the world's population. A new generation of atypical antipsychotics has been introduced over the past decade. These atypical antipsychotics have comparable or greater efficacy than traditional antipsychotics in the treatment of the psychotic symptoms of schizophrenia and a much improved neurologic side effect profile. This paper reviews the pharmacological efficacy and safety of a potential atypical antipsychotic, NRA0562. NRA0562 has a high affinity for dopamine D1, D2L, D4.2, 5-HT2A receptors as well as alpha1-adrenoceptors, and has a moderate affinity for H1 receptors. NRA0562 strongly binds to 5-HT2A receptors and alpha1-adrenoceptors in the frontal cortex, its binding to striatal D2 receptors is weaker, similar to that of clozapine. NRA562 displayed potent antipsychotic activities in animal models of schizophrenia, such as methamphetamine (MAP)-induced hyperactivity, apomorphine-induced disruption of pre-pulse inhibition and conditioned avoidance test. NRA0562 is more potent in reversing the inhibitory effects of MAP at A10 than at A9 dopamine neurons. It increased Fos-like immunoreactivity in the nucleus accumbens more effectively than in the dorsolateral striatum, indicating that NRA0562 has the profile of an atypical antipsychotic. In vivo assays for extrapyramidal side effect liability showed that NRA0562 has a low rate of neurological side effects. Thus, NRA0562 may have unique antipsychotic activity with a lower propensity for extrapyramidal side effects.
精神分裂症是一种严重的致残性精神障碍,影响着全球约1%的人口。在过去十年中,新一代非典型抗精神病药物被引入。这些非典型抗精神病药物在治疗精神分裂症的精神病症状方面具有与传统抗精神病药物相当或更高的疗效,并且神经副作用明显改善。本文综述了一种潜在的非典型抗精神病药物NRA0562的药理疗效和安全性。NRA0562对多巴胺D1、D2L、D4.2、5-HT2A受体以及α1-肾上腺素能受体具有高亲和力,对H1受体具有中等亲和力。NRA0562在额叶皮质中与5-HT2A受体和α1-肾上腺素能受体强烈结合,其与纹状体D2受体的结合较弱,类似于氯氮平。NRA562在精神分裂症动物模型中表现出强效抗精神病活性,如甲基苯丙胺(MAP)诱导的多动、阿扑吗啡诱导的前脉冲抑制破坏和条件回避试验。NRA0562在逆转A10处MAP的抑制作用方面比在A9多巴胺神经元处更有效。它在伏隔核中比在背外侧纹状体中更有效地增加了Fos样免疫反应性,表明NRA0562具有非典型抗精神病药物的特征。锥体外系副作用易感性的体内试验表明,NRA0562的神经副作用发生率较低。因此,NRA0562可能具有独特的抗精神病活性,锥体外系副作用倾向较低。