School of Medicine, Deakin University, Geelong, Victoria, Australia; Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia.
Prog Neuropsychopharmacol Biol Psychiatry. 2013 Apr 5;42:135-45. doi: 10.1016/j.pnpbp.2012.11.007. Epub 2012 Nov 23.
In many individuals with major neuropsychiatric disorders including depression, bipolar disorder and schizophrenia, their disease characteristics are consistent with a neuroprogressive illness. This includes progressive structural brain changes, cognitive and functional decline, poorer treatment response and an increasing vulnerability to relapse with chronicity. The underlying molecular mechanisms of neuroprogression are thought to include neurotrophins and regulation of neurogenesis and apoptosis, neurotransmitters, inflammatory, oxidative and nitrosative stress, mitochondrial dysfunction, cortisol and the hypothalamic-pituitary-adrenal axis, and epigenetic influences. Knowledge of the involvement of each of these pathways implies that specific agents that act on some or multiple of these pathways may thus block this cascade and have neuroprotective properties. This paper reviews the potential of the most promising of these agents, including lithium and other known psychotropics, aspirin, minocycline, statins, N-acetylcysteine, leptin and melatonin. These agents are putative neuroprotective agents for schizophrenia and mood disorders.
在许多患有重大神经精神疾病的个体中，包括抑郁症、双相情感障碍和精神分裂症，他们的疾病特征与神经进行性疾病一致。这包括进行性的结构性脑变化、认知和功能下降、治疗反应较差以及随着慢性化而增加复发的易感性。神经进行性的潜在分子机制被认为包括神经营养因子和神经发生和细胞凋亡的调节、神经递质、炎症、氧化和硝化应激、线粒体功能障碍、皮质醇和下丘脑-垂体-肾上腺轴以及表观遗传影响。对这些途径中的每一种的参与的了解意味着作用于这些途径中的一些或多种的特定药物可能因此阻断这种级联反应并具有神经保护特性。本文综述了这些药物中最有前途的药物的潜力，包括锂和其他已知的精神药物、阿司匹林、米诺环素、他汀类药物、N-乙酰半胱氨酸、瘦素和褪黑素。这些药物是精神分裂症和心境障碍的潜在神经保护剂。
