Abi-Dargham A, Laruelle M, Aghajanian G K, Charney D, Krystal J
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
J Neuropsychiatry Clin Neurosci. 1997 Winter;9(1):1-17. doi: 10.1176/jnp.9.1.1.
The concept of "balanced serotonergic/dopaminergic antagonists" reflects renewed interest in the role of serotonin (5-HT) in schizophrenia. Postmortem brain tissue analysis, cerebrospinal fluid studies, and pharmacological challenges suggest a deficit in 5-HT function in the cortex of patients with schizophrenia. In contrast, however, 5-HT2 antagonism is claimed to have beneficial effects on both positive and negative symptoms of the illness. The authors attempt to resolve this paradox with a model that takes into account the suggestion of a cortical serotonergic hypofunction and a beneficial effect of 5-HT2 antagonism via modulation of subcortical dopamine activity. Although involvement of 5-HT in schizophrenia is supported by compelling evidence, more research is needed to better define its role in pathophysiology and treatment of this illness.
“平衡的血清素能/多巴胺能拮抗剂”这一概念反映出人们对血清素（5-羟色胺，5-HT）在精神分裂症中作用的重新关注。对死后脑组织的分析、脑脊液研究以及药理学激发试验表明，精神分裂症患者的皮质中5-HT功能存在缺陷。然而，相比之下，5-HT2拮抗剂据称对该疾病的阳性和阴性症状均具有有益作用。作者试图通过一个模型来解决这一矛盾，该模型考虑到了皮质血清素能功能减退的观点以及通过调节皮质下多巴胺活性产生的5-HT2拮抗作用的有益效果。尽管有确凿证据支持5-HT参与精神分裂症，但仍需要更多研究来更好地明确其在该疾病病理生理学和治疗中的作用。
