Lieberman Jeffrey A, Bymaster Frank P, Meltzer Herbert Y, Deutch Ariel Y, Duncan Gary E, Marx Christine E, Aprille June R, Dwyer Donard S, Li Xin-Min, Mahadik Sahebarao P, Duman Ronald S, Porter Joseph H, Modica-Napolitano Josephine S, Newton Samuel S, Csernansky John G
Department of Psychiatry, Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute, 1051 Riverside Dr., Unit 4, New York, NY 10032, USA.
Pharmacol Rev. 2008 Sep;60(3):358-403. doi: 10.1124/pr.107.00107.
Various lines of evidence indicate the presence of progressive pathophysiological processes occurring within the brains of patients with schizophrenia. By modulating chemical neurotransmission, antipsychotic drugs may influence a variety of functions regulating neuronal resilience and viability and have the potential for neuroprotection. This article reviews the current literature describing preclinical and clinical studies that evaluate the efficacy of antipsychotic drugs, their mechanism of action and the potential of first- and second-generation antipsychotic drugs to exert effects on cellular processes that may be neuroprotective in schizophrenia. The evidence to date suggests that although all antipsychotic drugs have the ability to reduce psychotic symptoms via D(2) receptor antagonism, some antipsychotics may differ in other pharmacological properties and their capacities to mitigate and possibly reverse cellular processes that may underlie the pathophysiology of schizophrenia.
多方面的证据表明,精神分裂症患者大脑中存在进行性病理生理过程。通过调节化学神经传递,抗精神病药物可能会影响多种调节神经元弹性和活力的功能,并具有神经保护潜力。本文综述了当前的文献,这些文献描述了评估抗精神病药物疗效、其作用机制以及第一代和第二代抗精神病药物对可能在精神分裂症中具有神经保护作用的细胞过程产生影响的潜力的临床前和临床研究。迄今为止的证据表明,尽管所有抗精神病药物都有能力通过拮抗D(2)受体来减轻精神病症状,但一些抗精神病药物在其他药理学特性以及减轻并可能逆转可能是精神分裂症病理生理学基础的细胞过程的能力方面可能存在差异。