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精神药理学方法在治疗主要抑郁障碍中的神经可塑性和神经发生作用。

Psychopharmacological Approaches for Neural Plasticity and Neurogenesis in Major Depressive Disorders.

机构信息

Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.

School of Pharmacy, Lebanese American University, Beirut, Lebanon.

出版信息

Adv Exp Med Biol. 2024;1456:27-48. doi: 10.1007/978-981-97-4402-2_2.

Abstract

Major depressive disorder (MDD) is a mental health disorder associated with cognitive impairment, dysregulated appetite, fatigue, insomnia or hypersomnia, and severe mood changes that significantly impact the ability of the affected individual to perform day-to-day tasks, leading to suicide in the worst-case scenario. As MDD is becoming more prevalent, affecting roughly 300 million individuals worldwide, its treatment has become a major point of interest. Antidepressants acting as selective serotonin reuptake inhibitors (SSRIs) are currently used as the first line of treatment for MDD. Other antidepressants currently used for the treatment of MDD include the serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs). However, although effective in alleviating symptoms of MDD, most antidepressants require weeks or even months of regular administration prior to eliciting a rational clinical effect. Owing to the strong evidence showing a relationship between neural plasticity, neurogenesis, and MDD, researchers have also looked at the possibility of using treatment modalities that target these processes in an attempt to improve clinical outcome. The overarching aim of this chapter is to highlight the role of neural plasticity and neurogenesis in the pathophysiology of MDD and discuss the most recently studied treatment strategies that target these processes by presenting supporting evidence from both animal and human studies.

摘要

重度抑郁症(MDD)是一种与认知障碍、食欲失调、疲劳、失眠或嗜睡、严重情绪变化有关的心理健康障碍,这些变化极大地影响了受影响个体执行日常任务的能力,在最坏的情况下会导致自杀。由于 MDD 的发病率越来越高,影响了全球约 3 亿人,因此其治疗已成为一个主要关注点。作为 MDD 一线治疗药物的选择性 5-羟色胺再摄取抑制剂(SSRIs)类抗抑郁药目前正在使用中。目前用于治疗 MDD 的其他抗抑郁药包括 5-羟色胺和去甲肾上腺素再摄取抑制剂(SNRIs)、三环类抗抑郁药(TCAs)和单胺氧化酶抑制剂(MAOIs)。然而,尽管这些药物在缓解 MDD 症状方面有效,但大多数抗抑郁药需要数周甚至数月的常规给药才能产生合理的临床效果。由于有强有力的证据表明神经可塑性、神经发生与 MDD 之间存在关系,因此研究人员也研究了使用针对这些过程的治疗方法的可能性,试图改善临床结果。本章的总体目标是强调神经可塑性和神经发生在 MDD 病理生理学中的作用,并讨论最近研究的针对这些过程的治疗策略,同时从动物和人类研究中提供支持证据。

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