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精神分裂症治疗中的新型化合物——一项选择性综述

Novel Compounds in the Treatment of Schizophrenia-A Selective Review.

作者信息

Tsapakis Evangelia Maria, Diakaki Kalliopi, Miliaras Apostolos, Fountoulakis Konstantinos N

机构信息

3rd Department of Academic Psychiatry, AHEPA General Hospital, 546 36 Thessaloniki, Greece.

Department of Psychiatry, Academic General Hospital, 711 10 Heraklion, Greece.

出版信息

Brain Sci. 2023 Aug 11;13(8):1193. doi: 10.3390/brainsci13081193.

Abstract

Schizophrenia is a chronic neuropsychiatric syndrome that significantly impacts daily function and quality of life. All of the available guidelines suggest a combined treatment approach with pharmacologic agents and psychological interventions. However, one in three patients is a non-responder, the effect on negative and cognitive symptoms is limited, and many drug-related adverse effects complicate clinical management. As a result, discovering novel drugs for schizophrenia presents a significant challenge for psychopharmacology. This selective review of the literature aims to outline the current knowledge on the aetiopathogenesis of schizophrenia and to present the recently approved and newly discovered pharmacological substances in treating schizophrenia. We discuss ten novel drugs, three of which have been approved by the FDA (Olanzapine/Samidorphan, Lumateperone, and Pimavanserin). The rest are under clinical trial investigation (Brilaroxazine, Xanomeline/Trospium, Emraclidine, Ulotaront, Sodium Benzoate, Luvadaxistat, and Iclepertin). However, additional basic and clinical research is required not only to improve our understanding of the neurobiology and the potential novel targets in the treatment of schizophrenia, but also to establish more effective therapeutical interventions for the syndrome, including the attenuation of negative and cognitive symptoms and avoiding dopamine blockade-related adverse effects.

摘要

精神分裂症是一种慢性神经精神综合征,会对日常功能和生活质量产生重大影响。所有现行指南均建议采用药物治疗与心理干预相结合的治疗方法。然而,三分之一的患者没有反应,对阴性和认知症状的疗效有限,而且许多药物相关的不良反应使临床管理变得复杂。因此,寻找治疗精神分裂症的新药对精神药理学来说是一项重大挑战。这篇文献综述旨在概述目前关于精神分裂症病因发病机制的知识,并介绍最近批准和新发现的治疗精神分裂症的药物。我们讨论了十种新药,其中三种已获美国食品药品监督管理局(FDA)批准(奥氮平/沙美阿片、鲁马哌酮和匹莫范色林)。其余药物正在进行临床试验研究(布立拉嗪、占诺美林/曲司氯铵、埃马氯氮平、乌洛托品、苯甲酸钠、鲁伐达西他和依克立肽)。然而,不仅需要更多的基础和临床研究来增进我们对精神分裂症神经生物学及潜在新靶点的理解,还需要建立更有效的针对该综合征的治疗干预措施,包括减轻阴性和认知症状以及避免与多巴胺阻断相关的不良反应。

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