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[抑郁症治疗的新选择]

[New options in the treatment of depression].

作者信息

Frieling H, Hillemacher T, Demling J H, Kornhuber J, Bleich S

机构信息

Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen.

出版信息

Fortschr Neurol Psychiatr. 2007 Nov;75(11):641-52. doi: 10.1055/s-2007-959181. Epub 2007 Mar 16.

Abstract

Despite the advances in the psychopharmacology, the treatment of depressive disorder is still not satisfactory. All current pharmacological substances are affecting the monoamines in the central nervous system. The present review discusses advances in the field of monoaminergic antidepressants as well as new treatment alternatives. The new monoaminergic substances include metabolites of known antidepressants, direct serotonin-agonists, and triple-reuptake inhibitors, blocking the transport of serotonin, norepinephrine, and dopamine. Non-monoaminergic strategies include substances affecting melatonin or neuropeptides. Glutamate modulating agents such as ketamine or riluzole are another promising approach in the treatment of depression. Some advances have also been achieved in the field of HPA-axis modulation.

摘要

尽管精神药理学取得了进展,但抑郁症的治疗仍不尽人意。目前所有的药物都作用于中枢神经系统中的单胺类物质。本综述讨论了单胺能抗抑郁药领域的进展以及新的治疗选择。新的单胺能物质包括已知抗抑郁药的代谢产物、直接的5-羟色胺激动剂以及三重再摄取抑制剂,后者可阻断5-羟色胺、去甲肾上腺素和多巴胺的转运。非单胺能策略包括作用于褪黑素或神经肽的物质。谷氨酸调节剂如氯胺酮或利鲁唑是治疗抑郁症的另一种有前景的方法。在HPA轴调节领域也取得了一些进展。

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