Romanov D V, Sheyanov A M, Samsonova M D, Iuzbashian P G
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Mental Health Research Center, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(12):20-26. doi: 10.17116/jnevro202312312120.
The purpose of this review is to correlate current data on the molecular mechanisms of action of the drug Nimodipine with its clinical effects and applicability in mental disorders belonging to the spectrum of affective pathology. The article discusses the prospects for using the calcium channel blocker nimodipine as a method of both mono and combination therapy for bipolar disorders with various types of course. Nimodipine is a selective blocker of voltage-dependent calcium channels, a dihydropyridine derivative. By blocking L type calcium channels, it prevents the entry of calcium ions into the cell. Due to its pronounced ability to penetrate the blood-brain barrier, it has a selective effect on brain neurons and has a vasodilating, antihypertensive and normotimic effect. Nimodipine blocks LTCC channels in brain neurons, thereby influencing synaptic plasticity, transmitter release and excitation-transcription coupling, which makes it possible to influence various clinical conditions with pathology in the area of affect, including bipolar disorders with ultra-rapid cycling, and also, in cases with high resistance and intolerance to other mood stabilizers.
本综述的目的是将有关药物尼莫地平作用分子机制的当前数据与其临床效果以及在属于情感病理学范畴的精神障碍中的适用性相关联。本文讨论了将钙通道阻滞剂尼莫地平用作各种病程类型双相情感障碍的单一疗法和联合疗法的前景。尼莫地平是电压依赖性钙通道的选择性阻滞剂,一种二氢吡啶衍生物。通过阻断L型钙通道,它可防止钙离子进入细胞。由于其具有显著的穿透血脑屏障的能力,它对脑神经元具有选择性作用,并具有血管舒张、抗高血压和心境稳定作用。尼莫地平阻断脑神经元中的L型钙通道,从而影响突触可塑性、神经递质释放和兴奋-转录偶联,这使得它有可能影响情感领域存在病理状况的各种临床病症,包括超快速循环型双相情感障碍,以及在对其他心境稳定剂具有高耐药性和不耐受性的情况下。