Department of Pharmacology and Toxicology, University at Buffalo, The State University of New York, Buffalo, NY, 14203, USA.
Acta Pharmacol Sin. 2018 Dec;39(12):1823-1829. doi: 10.1038/s41401-018-0180-x. Epub 2018 Oct 31.
Drug addiction is a chronic, relapsing brain disorder. Multiple neural networks in the brain including the reward system (e.g., the mesocorticolimbic system), the anti-reward/stress system (e.g., the extended amygdala), and the central immune system, are involved in the development of drug addiction and relapse after withdrawal from drugs of abuse. Preclinical and clinical studies have demonstrated that it is promising to control drug addiction by pharmacologically targeting the addiction-related systems in the brain. Here we review the pharmacological targets within the dopamine system, glutamate system, trace amine system, anti-reward system, and central immune system, which are of clinical interests. Furthermore, we discuss other potential therapies, e.g., brain stimulation, behavioral treatments, and therapeutic gene modulation, which could be effective to treat drug addiction. We conclude that, although drug addiction is a complex disorder that involves complicated neural mechanisms and psychological processes, this mental disorder is treatable and may be curable by therapies such as gene modulation in the future.
药物成瘾是一种慢性、复发性的大脑疾病。大脑中的多个神经网络，包括奖励系统（例如，中脑边缘奖赏系统）、抗奖赏/应激系统（例如，扩展的杏仁核）和中枢免疫系统，都参与了药物成瘾的发展以及戒断滥用药物后的复发。临床前和临床研究表明，通过药理学靶向大脑中与成瘾相关的系统来控制药物成瘾具有广阔的前景。在这里，我们综述了多巴胺系统、谷氨酸系统、痕量胺系统、抗奖赏系统和中枢免疫系统中的药理学靶点，这些靶点具有临床意义。此外，我们还讨论了其他潜在的治疗方法，例如脑刺激、行为治疗和治疗性基因调节，这些方法可能对治疗药物成瘾有效。我们的结论是，尽管药物成瘾是一种涉及复杂神经机制和心理过程的复杂疾病，但这种精神障碍是可治疗的，并且将来可能通过基因调节等治疗方法来治愈。
