神经性厌食症中的5-羟色胺能和多巴胺能系统：非典型抗精神病药物的作用？
Serotonergic and dopaminergic systems in anorexia nervosa: a role for atypical antipsychotics?
作者信息
Bosanac Peter, Norman Trevor, Burrows Graham, Beumont Peter
机构信息
Austin Health and Department of Psychiatry, The University of Melbourne, Austin Hospital, Austin Health, Victoria, Australia.
出版信息
Aust N Z J Psychiatry. 2005 Mar;39(3):146-53. doi: 10.1080/j.1440-1614.2005.01536.x.
OBJECTIVE
To review serotonergic and dopaminergic system function in anorexia nervosa in terms of potential modulation by atypical antipsychotic medications.
METHOD
A systematic review of clinical, neurobiological and functional neuroimaging findings of serotonergic and dopaminergic system activity in anorexia nervosa was conducted via MEDLINE, PsycINFO and EMBASE psychiatry databases, with a critical review of dysregulation of these systems as therapeutic targets for atypical antipsychotics, in context of evidence regarding the utility and efficacy of these medications in this syndrome.
RESULTS
There is evidence of persistently altered serotonergic and dopaminergic function in anorexia nervosa independent to weight-recovery. Case reports, open-label and single-blinded studies, albeit sparse, suggest that atypical antipsychotics may be beneficial in the management of anorexia nervosa psychopathology beyond weight gain.
CONCLUSIONS
Double-blind placebo controlled studies of atypical antipsychotics in anorexia nervosa with well defined outcome measures are required.
目的
从非典型抗精神病药物潜在调节作用的角度，综述神经性厌食症中血清素能和多巴胺能系统的功能。
方法
通过医学文献数据库（MEDLINE）、心理学文摘数据库（PsycINFO）和荷兰医学文摘数据库（EMBASE）精神病学数据库，对神经性厌食症中血清素能和多巴胺能系统活动的临床、神经生物学和功能性神经影像学研究结果进行系统综述，并结合这些药物在该综合征中的效用和疗效证据，对这些系统的失调作为非典型抗精神病药物治疗靶点进行批判性综述。
结果
有证据表明，神经性厌食症患者中血清素能和多巴胺能功能持续改变，且与体重恢复无关。病例报告、开放标签和单盲研究虽数量稀少，但表明非典型抗精神病药物可能有助于治疗神经性厌食症的精神病理学症状，而非仅仅促进体重增加。
结论
需要开展针对神经性厌食症的非典型抗精神病药物双盲安慰剂对照研究，并采用明确的疗效指标。
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