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长期给予抗抑郁治疗对强迫症相关脑区5-羟色胺释放的影响。

Effect of long-term administration of antidepressant treatments on serotonin release in brain regions involved in obsessive-compulsive disorder.

作者信息

Bergqvist P B, Bouchard C, Blier P

机构信息

Department of Psychiatry, McGill University, Montréal, Québec, Canada.

出版信息

Biol Psychiatry. 1999 Jan 15;45(2):164-74. doi: 10.1016/s0006-3223(98)00154-1.

Abstract

BACKGROUND

Among all antidepressant treatments, including electroconvulsive shock (ECS) therapy and monoamine oxidase inhibitors (MAOIs), only the selective serotonin (5-HT) reuptake inhibitors (SSRIs) exert a clear therapeutic effect in obsessive-compulsive disorder (OCD). An 8-week, but not a 3-week treatment with the SSRI paroxetine results in an increased electrically evoked [3H]5-HT release and a desensitization of 5-HT autoreceptors in the guinea pig orbitofrontal cortex, a brain region implicated in OCD.

METHODS

In the present study, the effect of long-term treatment with the SSRI fluoxetine, ECS, and the reversible type A MAOI moclobemide was investigated on evoked [3H]5-HT release from preloaded guinea pig brain slices prepared from the hypothalamus, cingulate cortex, and orbitofrontal cortex.

RESULTS

Fluoxetine treatment yielded an enhanced [3H]5-HT release in the three brain areas, but a desensitization of the 5-HT autoreceptor only in the hypothalamus and orbitofrontal cortex. ECS treatment did not result in any alteration of the electrically evoked [3H]5-HT release or of 5-HT autoreceptor sensitivity in any of the brain regions. Moclobemide increased [3H]5-HT release only in the orbitofrontal cortex without any alteration in the 5-HT autoreceptor sensitivity.

CONCLUSIONS

These findings indicate that only treatments effective in OCD have the capacity to desensitize the terminal 5-HT autoreceptor in the orbitofrontal cortex.

摘要

背景

在所有抗抑郁治疗方法中,包括电休克疗法(ECS)和单胺氧化酶抑制剂(MAOIs),只有选择性5-羟色胺(5-HT)再摄取抑制剂(SSRIs)对强迫症(OCD)有明确的治疗效果。用SSRI帕罗西汀进行为期8周而非3周的治疗,会导致豚鼠眶额皮质(一个与强迫症有关的脑区)中电诱发的[3H]5-HT释放增加以及5-HT自身受体脱敏。

方法

在本研究中,研究了用SSRI氟西汀、ECS和可逆性A型MAOI吗氯贝胺进行长期治疗对从豚鼠下丘脑、扣带回皮质和眶额皮质制备的预加载脑片诱发的[3H]5-HT释放的影响。

结果

氟西汀治疗使三个脑区的[3H]5-HT释放增强,但仅使下丘脑和眶额皮质中的5-HT自身受体脱敏。ECS治疗未导致任何脑区中电诱发的[3H]5-HT释放或5-HT自身受体敏感性发生改变。吗氯贝胺仅使眶额皮质中的[3H]5-HT释放增加,而5-HT自身受体敏感性未发生任何改变。

结论

这些发现表明,只有对强迫症有效的治疗方法才有能力使眶额皮质中的终末5-HT自身受体脱敏。

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