Department of Psychosis Studies, Institute of Psychiatry, Kings College London, London, United Kingdom.
Am J Med Genet B Neuropsychiatr Genet. 2013 Oct;162B(7):661-70. doi: 10.1002/ajmg.b.32177.
When drug-induced psychoses were first identified in the mid-20th century, schizophrenia was considered a discrete disease with a likely genetic cause. Consequently, drug-induced psychoses were not considered central to understanding schizophrenia as they were thought to be phenocopies rather than examples of the illness secondary to a particular known cause. However, now that we know that schizophrenia is a clinical syndrome with multiple component causes, then it is clear that the drug-induced psychoses have much to teach us. This article shows how the major neuropharmacological theories of schizophrenia have their origins in studies of the effects of drugs of abuse. Research into the effects of LSD initiated the serotonergic model; amphetamines the dopamine hypothesis, PCP and ketamine the glutamatergic hypothesis, while most recently the effects of cannabis have provoked interest in the role of endocannabinoids in schizophrenia. None of these models account for the complete picture of schizophrenia; rather the various drug models mimic different aspects of the illness. Determining the different molecular effects of those drugs whose pharmacological effects do and do not mimic the various aspects of schizophrenia has much to teach us concerning the pathogenesis of the illness.
当药物引起的精神病在 20 世纪中期首次被确定时,精神分裂症被认为是一种具有潜在遗传原因的离散疾病。因此,药物引起的精神病并不被认为是理解精神分裂症的核心,因为它们被认为是表型而不是由于特定已知原因引起的疾病的例子。然而,既然我们知道精神分裂症是一种具有多种组成原因的临床综合征,那么很明显,药物引起的精神病有很多值得我们学习的地方。本文展示了精神分裂症的主要神经药理学理论是如何起源于对滥用药物影响的研究的。对 LSD 影响的研究引发了血清素能模型;安非他命引发了多巴胺假说,PCP 和氯胺酮引发了谷氨酸假说,而最近大麻的影响引起了人们对精神分裂症中内源性大麻素作用的兴趣。这些模型都不能解释精神分裂症的全貌;相反,各种药物模型模拟了疾病的不同方面。确定那些药物的不同分子效应,这些药物的药理作用既可以模拟也可以不模拟精神分裂症的各个方面,对于我们了解疾病的发病机制有很大的帮助。