Uniwersytet Medyczny w Łodzi.
Psychiatr Pol. 2024 Aug 31;58(4):581-593. doi: 10.12740/PP/174593.
Since the 1950s, there have been rapid developments in psychiatric pharmacotherapy, resulting not only in more effective treatment of patients, but also in improvements in minimizing adverse effects of therapy. Modern third-generation antipsychotics, in addition to antagonism toward D2 receptors, also exhibit partial agonism toward dopamine receptors. Such a mechanism of action is intended to regulate dopaminergic transmission - inhibit (antagonism) it in pathways where it is excessive (excessive transmission in the mesolimbic pathway in psychotic patients, excessive transmission in the tuberoinfundibular pathway in patients with hyperprolactinemia) and stimulate (agonism) it in pathways where it is too low (mesocortical pathway). This has a beneficial effect on both the reduction of adverse symptoms and the negative, affective and cognitive symptoms of patients suffering from schizophrenia. The purpose of this review article is to present the most important clinical aspects of the use of dopamine D2 receptor partial agonists in the treatment of schizophrenia, using brexpiprazole as an example, and to define the profile of patients to whom this drug could be dedicated - based on recent studies.
自 20 世纪 50 年代以来，精神药理学治疗取得了快速发展，不仅使患者的治疗效果得到了提高，而且还减少了治疗的不良反应。现代第三代抗精神病药物除了对 D2 受体的拮抗作用外，还对多巴胺受体具有部分激动作用。这种作用机制旨在调节多巴胺能传递——抑制（拮抗）在过度的途径中（精神分裂症患者中边缘中脑通路的过度传递，高催乳素血症患者中结节漏斗通路的过度传递），并刺激（激动）在过低的途径中（中皮质通路）。这对减少不良反应以及减轻患有精神分裂症的患者的阴性、情感和认知症状都有有益的影响。本文的目的是介绍使用多巴胺 D2 受体部分激动剂治疗精神分裂症的最重要的临床方面，以 brexpiprazole 为例，并根据最近的研究，确定适合使用这种药物的患者群体。
