Colucci Luisa, Bosco Massimiliano, Rosario Ziello Antonio, Rea Raffaele, Amenta Francesco, Fasanaro Angiola Maria
Centro di Ricerche Cliniche, Telemedicina e Telefarmacia, Università di Camerino, Camerino, Italy; Unità Valutazione Alzheimer, Naples, Italy.
Unità Valutazione Alzheimer, Naples, Italy.
J Exp Pharmacol. 2012 Dec 11;4:163-72. doi: 10.2147/JEP.S35326. eCollection 2012.
Nootropics represent probably the first "smart drugs" used for the treatment of cognitive deficits. The aim of this paper is to verify, by a systematic analysis of the literature, the effectiveness of nootropics in this indication. The analysis was limited to nootropics with cholinergic activity, in view of the role played by acetylcholine in learning and memory. Acetylcholine was the first neurotransmitter identified in the history of neuroscience and is the main neurotransmitter of the peripheral, autonomic, and enteric nervous systems. We conducted a systematic review of the literature for the 5-year period 2006-2011. From the data reported in the literature, it emerges that nootropics may be an effective alternative for strengthening and enhancing cognitive performance in patients with a range of pathologies. Although nootropics, and specifically the cholinergic precursors, already have a long history behind them, according to recent renewal of interest, they still seem to have a significant therapeutic role. Drugs with regulatory indications for symptomatic treatment of Alzheimer's disease, such as cholinesterase inhibitors and memantine, often have transient effects in dementia disorders. Nootropics with a cholinergic profile and documented clinical effectiveness in combination with cognate drugs such as cholinesterase inhibitors or alone in patients who are not suitable for these inhibitors should be taken into account and evaluated further.
益智药可能是最早用于治疗认知缺陷的“智能药物”。本文的目的是通过对文献的系统分析，验证益智药在这一适应症中的有效性。鉴于乙酰胆碱在学习和记忆中所起的作用，分析仅限于具有胆碱能活性的益智药。乙酰胆碱是神经科学史上发现的第一种神经递质，是外周、自主和肠神经系统的主要神经递质。我们对2006年至2011年这5年期间的文献进行了系统综述。从文献报道的数据来看，益智药可能是增强和提高一系列疾病患者认知能力的有效替代方法。尽管益智药，特别是胆碱能前体，已有很长的历史，但根据最近重新燃起的兴趣，它们似乎仍具有重要的治疗作用。有治疗阿尔茨海默病症状性治疗适应证的药物，如胆碱酯酶抑制剂和美金刚，在痴呆症中往往只有短暂的效果。应考虑并进一步评估具有胆碱能特性且有文献记载临床有效性的益智药，它们可与胆碱酯酶抑制剂等同类药物联合使用，或单独用于不适合使用这些抑制剂的患者。
