Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
Int Clin Psychopharmacol. 2022 May 1;37(3):82-83. doi: 10.1097/YIC.0000000000000402.
The origin of modern psychopharmacology dates to the 50s, with the discovery of imipramine and chlorpromazine. At present, we can choose among over 100 different compounds, which are effective in many psychiatric disturbances but are far from perfect in terms of efficacy and tolerability. The main limitation of available treatments is their lack in specificity, both in terms of pharmacologic targets and regional brain specificity. Several new compounds with innovative mechanisms of action have been recently approved; however, pharmacologic treatments targeted for specific tissues are still not available. Recent imaging and genetic findings suggest that we may be close to discovering the regional pathophysiologic mechanisms of psychiatric disorders. Targeted treatment to specific proteins or even genes may be possible using monoclonal antibodies, RNA silencing, gene editing or drug repurposing. We may be therefore close to a shift of paradigm in the treatment of psychiatric disorders, with innovative and targeted treatments.
现代精神药理学的起源可以追溯到 50 年代，当时发现了丙咪嗪和氯丙嗪。目前，我们可以选择 100 多种不同的化合物，这些化合物在许多精神障碍中都有效，但在疗效和耐受性方面还远非完美。现有治疗方法的主要局限性在于其缺乏特异性，无论是在药理靶点还是区域脑特异性方面。最近已经批准了几种具有创新作用机制的新化合物；然而，针对特定组织的药物治疗仍不可用。最近的影像学和遗传学研究结果表明，我们可能即将发现精神障碍的区域病理生理学机制。使用单克隆抗体、RNA 沉默、基因编辑或药物再利用，针对特定蛋白质甚至基因的靶向治疗可能成为可能。因此，我们可能即将在精神障碍的治疗方面实现范式的转变，采用创新和靶向治疗。
