Morley J E
Geriatric Research, Education and Clinical Center, Sepulveda VA Medical Center, Calif.
Neuropsychobiology. 1989;21(1):22-30. doi: 10.1159/000118547.
This review covers some modern concepts in the development of drugs to treat appetite disorders. Specific attention is paid to the peripheral satiety system and the role of gastrointestinal peptides such as cholecystokinin in the pathogenesis of satiety. Alterations in neuropeptide Y and/or peptide YY are suggested to play a role in the pathophysiology of bulimia. Corticotropin-releasing factor is a putative candidate peptide involved in anorexia nervosa. The serotonin reuptake inhibitors fenfluramine and fluoxetene decrease weight in obese subjects. Endogenous opioids modulate the choice of palatable foods. Anorexia in the old appears to be related to a decrease in opioid feeding drive and an excess of the satiety action of cholecystokinin. Other agents involved in weight regulation include those which alter gastric emptying, increase thermogenesis, or modulate fat cell metabolism. It should be stressed that many neurotransmitters that modulate appetite also alter other behaviors, increasing their propensity to produce side effects.
本综述涵盖了治疗食欲紊乱药物研发中的一些现代概念。特别关注外周饱腹感系统以及胃肠肽如胆囊收缩素在饱腹感发病机制中的作用。有人提出神经肽Y和/或肽YY的改变在贪食症的病理生理学中起作用。促肾上腺皮质激素释放因子是参与神经性厌食症的一种假定候选肽。5-羟色胺再摄取抑制剂芬氟拉明和氟西汀可使肥胖受试者体重减轻。内源性阿片类物质调节对美味食物的选择。老年人的厌食症似乎与阿片类进食驱动力降低和胆囊收缩素饱腹感作用过强有关。其他参与体重调节的药物包括那些改变胃排空、增加产热或调节脂肪细胞代谢的药物。应该强调的是，许多调节食欲的神经递质也会改变其他行为，增加其产生副作用的倾向。
