咖啡因、心理健康和精神障碍。
Caffeine, mental health, and psychiatric disorders.
机构信息
Faculdade de Biociências, PUCRS, Porto Alegre, Brazil.
出版信息
J Alzheimers Dis. 2010;20 Suppl 1:S239-48. doi: 10.3233/JAD-2010-1378.
Caffeine intake is so common that its pharmacological effects on the mind are undervalued. Since it is so readily available, individuals can adjust their own dose, time of administration and dose intervals of caffeine, according to the perceived benefits and side effects of each dose. This review focuses on human studies of caffeine in subjects with and without psychiatric disorders. Besides the possibility of mild drug dependence, caffeine may bring benefits that contribute to its widespread use. These benefits seem to be related to adaptation of mental energy to the context by increasing alertness, attention, and cognitive function (more evident in longer or more difficult tasks or situations of low arousal) and by elevating mood. Accordingly, moderate caffeine intake (< 6 cups/day) has been associated with less depressive symptoms, fewer cognitive failures, and lower risk of suicide. However, its putative therapeutic effects on depression and ADHD have been insufficiently studied. Conversely, in rare cases high doses of caffeine can induce psychotic and manic symptoms, and more commonly, anxiety. Patients with panic disorder and performance social anxiety disorder seem to be particularly sensitive to the anxiogenic effects of caffeine, whereas preliminary data suggests that it may be effective for some patients with obsessive compulsive disorder (OCD). The threshold for the anxiogenic effect of caffeine is influenced by a polymorphism of the A2A receptor. In summary, caffeine can be regarded as a pharmacological tool to increase energy and effortful behavior in daily activities. More populational (cross-sectional and prospective) and experimental studies are necessary to establish the role of caffeine intake in psychiatric disorders, especially its putative efficacy on depressive mood and cognitive/attentional disorders.
咖啡因摄入非常普遍,以至于其对大脑的药理作用被低估了。由于它很容易获得,个体可以根据每剂药物的益处和副作用来调整自己的剂量、给药时间和剂量间隔。本综述重点关注有和没有精神障碍的受试者中咖啡因的人体研究。除了轻度药物依赖的可能性外,咖啡因可能会带来一些益处,这有助于其广泛应用。这些益处似乎与通过提高警觉性、注意力和认知功能(在更长或更困难的任务或低唤醒状态下更为明显)以及改善情绪来适应精神能量与环境的关系有关。因此,适量摄入咖啡因(<6 杯/天)与抑郁症状减轻、认知失败减少和自杀风险降低有关。然而,其对抑郁症和 ADHD 的潜在治疗作用研究不足。相反,在极少数情况下,高剂量的咖啡因会引起精神病和躁狂症状,更常见的是焦虑。惊恐障碍和社交恐惧症患者似乎对咖啡因的焦虑作用特别敏感,而初步数据表明,它可能对一些强迫症(OCD)患者有效。咖啡因的焦虑作用阈值受 A2A 受体多态性的影响。总之,咖啡因可被视为一种增加日常活动中的精力和努力行为的药理学工具。需要进行更多的人群(横断面和前瞻性)和实验研究,以确定咖啡因摄入在精神障碍中的作用,特别是其对抑郁情绪和认知/注意力障碍的潜在疗效。