Cao Dan-Ni, Shi Jing-Jing, Hao Wei, Wu Ning, Li Jin
State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, 27th Taiping Road, Beijing 100850, China.
Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139th Renmin (M) Road, Changsha, Hunan 410011, China.
Eur J Pharmacol. 2016 Jun 5;780:129-35. doi: 10.1016/j.ejphar.2016.03.040. Epub 2016 Mar 24.
Addiction to amphetamine-type stimulants (ATS) is a serious worldwide public health problem with major medical, psychiatric and socioeconomic consequences. However, no approved pharmacological therapies are available to treat ATS addiction. Based on the neurobiological mechanisms underlying ATS addiction, the recent research works about pharmacological strategies have been focused on monoamine, glutamate, endogenous opioid peptide and γ-amino butyric acid (GABA) systems. This review summarizes the recent advances in the medications being developed to treat ATS addiction and discusses the remaining challenges. Although no substantial evidence for efficacious medications has emerged, some of these agents, including bupropion, naltrexone and mirtazapine, have demonstrated promise in clinical studies. Moreover, some challenges, such as the development of new preclinical animal models of drug addiction, the design of large-scale clinical trials with strict quality control, and the distinction of patients' genetic polymorphisms, need further attention. Despite the lack of success to date, much effort is being made to develop efficacious medications for treating ATS addiction.
苯丙胺类兴奋剂(ATS)成瘾是一个严重的全球性公共卫生问题,会导致重大的医学、精神和社会经济后果。然而,目前尚无获批的药物疗法可用于治疗ATS成瘾。基于ATS成瘾的神经生物学机制,近期有关药物策略的研究工作主要集中在单胺、谷氨酸、内源性阿片肽和γ-氨基丁酸(GABA)系统。本综述总结了目前正在研发的用于治疗ATS成瘾的药物的最新进展,并讨论了尚存的挑战。尽管尚未出现有效药物的实质性证据,但其中一些药物,包括安非他酮、纳曲酮和米氮平,已在临床研究中显示出前景。此外,一些挑战,如新的药物成瘾临床前动物模型的开发、具有严格质量控制的大规模临床试验的设计以及患者基因多态性的区分,需要进一步关注。尽管迄今为止尚未取得成功,但人们正在付出巨大努力来开发治疗ATS成瘾的有效药物。