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生酮饮食治疗精神分裂症:抗精神病药物治疗的营养方法。

Ketogenic diet for schizophrenia: Nutritional approach to antipsychotic treatment.

机构信息

Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.

Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.

出版信息

Med Hypotheses. 2018 Sep;118:74-77. doi: 10.1016/j.mehy.2018.06.022. Epub 2018 Jun 20.

Abstract

Schizophrenia is a mental disorder that mostly appears in the second or third decade of life with no consistent appearance. The first-line pharmacological treatment are antipsychotic drugs, which mainly act by suppressing the activity of dopamine. Unfortunately many of schizophrenic patients suffer from persistent positive or negative symptoms that cannot be fully treated with available medication. With exploration on the possible causes of the disease there is evidence on dopaminergic transmission defects, there is a need to find more holistic way in treating the disease and a diet regimen could be one of them. Ketogenic diet, which is a popular diet regimen that consists in low-carbohydrate (about 30-50 g/day), medium-protein (up to 1 g/kg daily) and high-fat intake (around 80% of daily calories) mainly known for its helpful role in weight-loss. The key mechanism is to generate ketosis. A state in which ketones bodies in the blood provides energy part of the body's energy comes from ketone bodies in the blood. Possible hypothesis can be that ketogenic diet changes the ratio of GABA:glutamate in favor of GABA, by suppressing the catabolism and increasing the synthesis of GABA as well as glutamate metabolism, which could help to compensate the disrupted GABA levels in schizophrenic brain, leading to possible better outcome of the disease regarding symptomatology and preventing the weight-gain regarding some medications used and the correlating diseases responsible for weight gain.

摘要

精神分裂症是一种精神障碍,主要出现在人生的第二或第三个十年,没有一致的表现。一线药物治疗是抗精神病药物,主要通过抑制多巴胺的活性起作用。不幸的是,许多精神分裂症患者患有持续的阳性或阴性症状,无法用现有药物充分治疗。随着对疾病可能原因的探索,有证据表明多巴胺能传递缺陷,因此需要寻找更全面的治疗方法,饮食方案可能是其中之一。生酮饮食是一种流行的饮食方案,其特点是低碳水化合物(约 30-50g/天)、中蛋白(高达 1g/kg/天)和高脂肪摄入(约 80%的日常热量),主要因其在减肥方面的有益作用而闻名。关键机制是产生酮症。酮体在血液中的状态,为身体的部分能量提供来源,血液中的酮体为身体的部分能量提供来源。可能的假设是,生酮饮食通过抑制 GABA 和谷氨酸的分解代谢以及增加 GABA 和谷氨酸代谢的合成,改变 GABA:谷氨酸的比例,有利于 GABA,这可能有助于补偿精神分裂症大脑中 GABA 水平的紊乱,从而导致疾病在症状学方面可能有更好的结果,并防止一些药物相关的体重增加以及与体重增加相关的疾病。

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