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[非典型抗精神病药物,药理学及临床意义]

[Atypical neuroleptics, pharmacology and clinical importance].

作者信息

Klages U, Hippius H, Müller-Spahn F

机构信息

Psychiatrische Klinik, Universität München.

出版信息

Fortschr Neurol Psychiatr. 1993 Nov;61(11):390-8. doi: 10.1055/s-2007-999110.

Abstract

Since the development of clozapine the investigation of atypical neuroleptic compounds has become increasingly relevant. Compared with classic neuroleptics they are distinguished by either fewer or absent (clozapine) extrapyramidal side effects, some of them also by lower increases of serum prolactin concentrations. Pharmacologically they are a group of heterogeneous substances. At the level of transmitter systems a high 5HT2/D2-ratio is regarded as the best criterion to distinguish between atypical and classic neuroleptics. Further differences involve: the preferred effects of atypical neuroleptics on mesolimbic D2 receptors compared to striatal dopaminergic neurotransmission; a higher potency of some atypical neuroleptics to antagonize D1-receptors; the increase of serum corticosterone concentrations by some of the atypical neuroleptics.

摘要

自氯氮平研发以来,非典型抗精神病药物的研究变得越来越重要。与经典抗精神病药物相比,它们的特点是锥体外系副作用较少或没有(氯氮平),其中一些药物还能使血清催乳素浓度升高幅度较小。从药理学角度来看,它们是一组异质性物质。在递质系统层面,高5HT2/D2比值被认为是区分非典型和经典抗精神病药物的最佳标准。进一步的差异包括:与纹状体多巴胺能神经传递相比,非典型抗精神病药物对中脑边缘D2受体具有优先作用;一些非典型抗精神病药物拮抗D1受体的效力更高;一些非典型抗精神病药物会使血清皮质酮浓度升高。

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