Hori Hiroaki, Kunugi Hiroshi
Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.
Psychogeriatrics. 2013 Sep;13(3):189-95. doi: 10.1111/psyg.12014.
Dopaminergic dysfunction is implicated in the pathophysiology of treatment-resistant depression. In this review, we describe the putative role of dopamine in depression, summarize the evidence for the efficacy of dopamine receptor agonists in the treatment of treatment-resistant depression, and discuss the underlying mechanisms by which these medications work. Both preclinical and clinical data suggest that adjunctive dopamine agonists could be a promising option for the treatment of such a condition, indicating that there is a dopamine agonist-responsive subgroup of depression. Future clinical studies are warranted to clarify unresolved issues regarding dopamine agonists such as long-term efficacy, efficacy as a monotherapy, and efficacy for juvenile and senile depression. Further basic research is also necessary to fully understand how dopamine acts in the brain of depressed patients.
多巴胺能功能障碍与难治性抑郁症的病理生理学有关。在本综述中，我们描述了多巴胺在抑郁症中的假定作用，总结了多巴胺受体激动剂治疗难治性抑郁症疗效的证据，并讨论了这些药物起作用的潜在机制。临床前和临床数据均表明，辅助使用多巴胺激动剂可能是治疗此类疾病的一个有前景的选择，这表明存在一个对多巴胺激动剂有反应的抑郁症亚组。未来有必要开展临床研究，以澄清有关多巴胺激动剂的未解决问题，如长期疗效、作为单一疗法的疗效以及对青少年和老年抑郁症的疗效。还需要进一步的基础研究，以全面了解多巴胺在抑郁症患者大脑中的作用方式。
