Carlezon William A, Konradi Christine
Department of Psychiatry, Harvard Medical School and McLean Hospital, MRC 217, 115 Mill Street, Belmont, MA 02478, USA.
Neuropharmacology. 2004;47 Suppl 1(0 1):47-60. doi: 10.1016/j.neuropharm.2004.06.021.
Children receive significant exposure to psychotropic drugs. Some psychiatric disorders are diagnosed and treated in children as young as 2 years old, resulting in exposure to prescription stimulants, antidepressants, and mood stabilizers during brain development. Difficulties in diagnoses at such young ages increase the likelihood that children who are not affected by these disorders receive drug exposure inadvertently. Additionally, the increased availability of caffeine-containing beverages in schools has facilitated exposure to this stimulant in children. However, the consequences of exposure to psychotropic drugs during brain development are not understood. When we exposed rats to the prescription stimulant methylphenidate during early adolescence, we discovered long-lasting behavioral and molecular alterations that were consistent with dramatic changes in the function of brain reward systems. In future work, it will be important to determine if other classes of psychotropic drugs cause these same effects, and whether these effects will also occur if drug exposure begins during other periods of development. Moreover, it will be critical to use more powerful behavioral methods that are sensitive to high-level aspects of motivation and cognitive function, and to establish causal links between developmental exposure-related alterations in these complex behaviors and specific alterations in the molecular biology of key brain regions. This approach may identify classes of psychotropic drugs that have high or low propensities to cause behavioral and molecular adaptations that endure into adulthood. It may also identify periods of development during which administration of these agents is particularly safe or risky.
儿童大量接触精神药物。一些精神疾病在年仅2岁的儿童中就被诊断和治疗,这导致他们在大脑发育期间接触到处方兴奋剂、抗抑郁药和情绪稳定剂。在如此年幼的年龄进行诊断存在困难,这增加了未受这些疾病影响的儿童无意中接触药物的可能性。此外,学校中含咖啡因饮料供应的增加促使儿童接触这种兴奋剂。然而,大脑发育期间接触精神药物的后果尚不清楚。当我们在青春期早期让大鼠接触处方兴奋剂哌甲酯时,我们发现了持久的行为和分子改变,这些改变与大脑奖赏系统功能的显著变化一致。在未来的研究中,确定其他类别的精神药物是否会产生同样的效果,以及如果在其他发育阶段开始接触药物这些效果是否也会出现,将是很重要的。此外,使用对动机和认知功能的高级方面敏感的更强大的行为方法,并在这些复杂行为中与发育性接触相关的改变和关键脑区分子生物学的特定改变之间建立因果联系,将至关重要。这种方法可能会识别出具有高或低倾向导致持续到成年期的行为和分子适应的精神药物类别。它还可能识别出服用这些药物特别安全或危险的发育阶段。