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重新审视苯二氮䓬类药物(GABA 增强剂):一种跨诊断和精准医学方法。

Revisiting benzodiazepines (GABA Enhancers):A transdiagnostic and precision medicine approach.

机构信息

Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, USA; Institute of Neuroscience, Florence, Italy.

Chaim Sheba Medical Center, Tel Aviv, Israel.

出版信息

J Psychiatr Res. 2024 Feb;170:65-72. doi: 10.1016/j.jpsychires.2023.11.042. Epub 2023 Dec 2.

Abstract

Since the mid 1980's, there has been an increased focus on the side effects of benzodiazepines (GABA enhancers), and as a result there has been a decrease in their use. We have systematically reviewed recent studies of GABA enhancers in psychiatry, and highlight evidence of their utility which may impact their negative conceptualization in clinical practice. We propose a new perspective on the appropriate use of these medications and describeclinical reasoning underpinning the use of benzodiazepine (GABA enhancers) based on their effect on specific receptors. A translational approach, involving a more comprehensive characterization of GABA receptors and their neuroscience-based mechanisms allows for a more precise use of this medication class. By adopting a precision person-centered approach, instead of a categorical approach, supports the prescribing of GABA enhancers when a cross-cutting transdiagnostic assessment shows anxiety symptoms associated with clinical impairment.

摘要

自 20 世纪 80 年代中期以来,人们越来越关注苯二氮䓬类药物(GABA 增强剂)的副作用,因此其使用有所减少。我们系统地回顾了精神病学中最近关于 GABA 增强剂的研究,并强调了它们的效用证据,这可能会影响它们在临床实践中的负面概念化。我们提出了一种新的观点,认为这些药物的使用是恰当的,并描述了基于这些药物对特定受体的影响而使用苯二氮䓬类药物(GABA 增强剂)的临床推理。一种转化方法,涉及对 GABA 受体及其基于神经科学的机制进行更全面的表征,允许更精确地使用此类药物。通过采用精准的以人为中心的方法,而不是分类方法,当跨诊断评估显示与临床损伤相关的焦虑症状时,支持开 GABA 增强剂的处方。

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