Schatzberg Alan F, Lindley Steven
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, United States.
Eur J Pharmacol. 2008 Apr 7;583(2-3):358-64. doi: 10.1016/j.ejphar.2008.01.001. Epub 2008 Jan 19.
Neuropsychiatric disorders often involve considerable psychological stress and elevated cortisol activity. Glucocorticoid receptors have relatively low affinity for cortisol and are found distributed throughout the brain, particularly in the frontal cortex and hippocampus. In recent years, glucocorticoid receptors antagonists have been actively studied in both animal models of several disorders as well as a potential treatment in specific types of neuropsychiatric patients. Data from these various studies are reviewed with an emphasis on seven clinical disorders or problems: major depression with psychotic features, bipolar disorder, schizophrenia, cognitive disorders, (e.g., Alzheimer's disease and mild cognitive impairment), cognitive side effects of electroconvulsive therapy, and weight gain with atypical antipsychotic agents. Potential benefits and limitations are discussed.
神经精神疾病通常涉及相当大的心理压力和皮质醇活性升高。糖皮质激素受体对皮质醇的亲和力相对较低,分布于整个大脑,尤其是额叶皮质和海马体。近年来,糖皮质激素受体拮抗剂在多种疾病的动物模型以及特定类型神经精神疾病患者的潜在治疗中都得到了积极研究。本文综述了这些不同研究的数据,重点关注七种临床疾病或问题:伴有精神病性特征的重度抑郁症、双相情感障碍、精神分裂症、认知障碍(如阿尔茨海默病和轻度认知障碍)、电休克治疗的认知副作用以及非典型抗精神病药物导致的体重增加。同时讨论了潜在的益处和局限性。