用于精神分裂症、双相情感障碍、阿尔茨海默病和帕金森病患者认知增强的药物。
Medications Used for Cognitive Enhancement in Patients With Schizophrenia, Bipolar Disorder, Alzheimer's Disease, and Parkinson's Disease.
作者信息
Hsu Wen-Yu, Lane Hsien-Yuan, Lin Chieh-Hsin
机构信息
Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
Changhua Christian Hospital, Changhua, Taiwan.
出版信息
Front Psychiatry. 2018 Apr 4;9:91. doi: 10.3389/fpsyt.2018.00091. eCollection 2018.
BACKGROUND/AIMS: Cognitive impairment, which frequently occurs in patients with schizophrenia, bipolar disorder, Alzheimer's disease, and Parkinson's disease, has a significant impact on the daily lives of both patients and their family. Furthermore, since the medications used for cognitive enhancement have limited efficacy, the issue of cognitive enhancement still remains a clinically unsolved challenge.
SAMPLING AND METHODS
We reviewed the clinical studies (published between 2007 and 2017) that focused on the efficacy of medications used for enhancing cognition in patients with schizophrenia, bipolar disorder, Alzheimer's disease, and Parkinson's disease.
RESULTS
Acetylcholinesterase inhibitors and memantine are the standard treatments for Alzheimer's disease and Parkinson's disease. Some studies have reported selective cognitive improvement in patients with schizophrenia following galantamine treatment. Newer antipsychotics, including paliperidone, lurasidone, aripiprazole, ziprasidone, and BL-1020, have also been reported to exert cognitive benefits in patients with schizophrenia. Dopaminergic medications were found to improve language function in patients with Parkinson's disease. However, no beneficial effects on cognitive function were observed with dopamine agonists in patients with schizophrenia. The efficacies of nicotine and its receptor modulators in cognitive improvement remain controversial, with the majority of studies showing that varenicline significantly improved the cognitive function in schizophrenic patients. Several studies have reported that -methyl-d-aspartate glutamate receptor (NMDAR) enhancers improved the cognitive function in patients with chronic schizophrenia. NMDAR enhancers might also have cognitive benefits in patients with Alzheimer's disease or Parkinson's disease. Raloxifene, a selective estrogen receptor modulator, has also been demonstrated to have beneficial effects on attention, processing speed, and memory in female patients with schizophrenia.
CONCLUSION
Clinical trials with larger sample sizes evaluating comprehensive cognitive domains are warranted to examine the efficacy of medications in cognitive enhancement in patients with schizophrenia, bipolar disorder, Alzheimer's disease, and Parkinson's disease.
背景/目的：认知障碍在精神分裂症、双相情感障碍、阿尔茨海默病和帕金森病患者中经常出现，对患者及其家人的日常生活都有重大影响。此外，由于用于认知增强的药物疗效有限，认知增强问题仍然是临床上尚未解决的挑战。
抽样与方法
我们回顾了2007年至2017年间发表的临床研究，这些研究聚焦于用于增强精神分裂症、双相情感障碍、阿尔茨海默病和帕金森病患者认知功能的药物疗效。
结果
乙酰胆碱酯酶抑制剂和美金刚是治疗阿尔茨海默病和帕金森病的标准药物。一些研究报告称，加兰他敏治疗后精神分裂症患者有选择性的认知改善。包括帕利哌酮、鲁拉西酮、阿立哌唑、齐拉西酮和BL - 1020在内的新型抗精神病药物也被报告对精神分裂症患者有认知益处。发现多巴胺能药物可改善帕金森病患者的语言功能。然而，多巴胺激动剂对精神分裂症患者的认知功能未观察到有益影响。尼古丁及其受体调节剂在认知改善方面的疗效仍存在争议，大多数研究表明伐尼克兰可显著改善精神分裂症患者的认知功能。几项研究报告称，N - 甲基 - D - 天冬氨酸谷氨酸受体（NMDAR）增强剂可改善慢性精神分裂症患者的认知功能。NMDAR增强剂对阿尔茨海默病或帕金森病患者可能也有认知益处。雷洛昔芬，一种选择性雌激素受体调节剂，也已被证明对女性精神分裂症患者的注意力、处理速度和记忆力有有益影响。
结论
有必要进行更大样本量的临床试验，评估全面的认知领域，以检验药物对精神分裂症、双相情感障碍、阿尔茨海默病和帕金森病患者认知增强的疗效。
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