Dripps Isaac J, Jutkiewicz Emily M
Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
Handb Exp Pharmacol. 2018;247:179-197. doi: 10.1007/164_2017_42.
Depression is a pervasive and debilitating mental disorder that is inadequately treated by current pharmacotherapies in a majority of patients. Although opioids have long been known to regulate mood states, the use of opioids to treat depression is rarely discussed. This chapter explores the preclinical and clinical evidence supporting the antidepressant-like effects of opioid ligands, and in particular, delta opioid receptor (DOR) agonists. DOR agonists have been shown to produce antidepressant-like effects in a number of animal models. Some DOR agonists also produce convulsions which has limited their clinical utility. However, DOR agonists that generate antidepressant-like effects without convulsions have recently been developed and these drugs are beginning to be evaluated in humans. Work investigating potential mechanisms of action for the antidepressant-like effects of DOR agonists is also explored. Understanding mechanisms that give rise to DOR-mediated behaviors is critical for the development of DOR drugs with improved safety and clinical utility, and future work should be devoted to elucidating these pathways.
抑郁症是一种普遍存在且使人衰弱的精神障碍,目前大多数患者采用的药物疗法对其治疗并不充分。尽管长期以来人们都知道阿片类药物可调节情绪状态,但很少有人讨论使用阿片类药物治疗抑郁症。本章探讨了支持阿片类配体,特别是δ阿片受体(DOR)激动剂具有抗抑郁样作用的临床前和临床证据。已证明DOR激动剂在多种动物模型中产生抗抑郁样作用。一些DOR激动剂还会引起惊厥,这限制了它们的临床应用。然而,最近已开发出能产生抗抑郁样作用而无惊厥的DOR激动剂,并且这些药物已开始在人体中进行评估。还探讨了研究DOR激动剂抗抑郁样作用潜在作用机制的工作。了解导致DOR介导行为的机制对于开发安全性和临床实用性更高的DOR药物至关重要,未来的工作应致力于阐明这些途径。