<strong>情感性精神障碍疾病治疗药物的研究现状</strong>

摘要/Abstract

摘要：情感性精神障碍包括抑郁症（又称单向情感精神障碍）和躁郁症（双相情感精神障碍），是最为常见的精神疾病，其发病率高、复发率高，社会危害严重。目前临床上治疗单向情感精神障碍的主要药物是以氟西汀、度罗西汀为代表的5-羟色胺选择性再摄取抑制剂（serotonin-specific reuptake inhibitors，SSRIs）和5-羟色胺/去甲肾上腺素双重再摄取抑制剂（serotonin/norepinephrine dual reuptake inhibitor，SNRIs）。治疗双相情感精神障碍的药物主要有碳酸锂、丙戊酸钠和卡马西平等。目前，关于这些药物的机制研究主要有以下几方面：①SSRIs上调细胞溶质型磷脂酶A2（cytosolic phospholipase A2，cPLA₂）、细胞外信号调控激酶（extracellular-signal regulated kinases，ERK）及c-Fos和FosB 基因表达增加；②腺苷酸脱氨酶（adenosine deaminase，ADAR2）介导氟西汀对5-HT_2B受体RNA编辑的调节作用；③碳酸锂、丙戊酸钠和卡马西平对cPLA_2a基因表达的长期调节作用及碱化细胞的作用。但现存的理论都不能明确解释药物的作用机制，并且有些研究结果仍存在尚待解决的问题。

关键词:抑郁症,5-羟色胺特异性再摄取抑制剂,碳酸锂,丙戊酸钠,卡马西平,细胞溶质型磷脂酶A₂,腺苷酸脱氨酶,细胞碱化

Abstract:Affective disorders including depression (also known as unipolar depression) and bipolar disorder (unipolar depression)，are the most common psychiatric disorders, which have high incidence ratio, high recurrence ratio, and is harmful to the society. Clinically, anti-unipolar depression drugs are mainly serotonin-specific reuptake inhibitors (SSRIs), fluoxetine as represented, and serotonin/norepinephrine dual reuptake inhibitor (SNRIs), duloxetine as represented. And lithium salts (Li⁺), valproate sodium, and carbamazepine are the three classical anti-bipolar drugs. At present, researches concerning these drugs propose following major mechanisms: ①The expression of cytosolic phospholipase A2 (cPLA₂), extracellular-signal regulated kinases (ERK) and c-Fos and FosB is increased by SSRIs; ②Chronic administration of Fluoxetine could induce 5-HT_2Breceptor pre-mRNA editing, with the help of adenosine deaminase (ADAR2) activity; ③Lithium carbonate, carbamazepine, valproate sodium could upregulate the mRNA and protein of cPLA_2aand induce alkalinization of cell. But the accurate pharmacological mechanisms of these drugs have not been fully elucidated and are needed to be further investigated.

Key words:depression,serotonin-specific reuptake inhibitors (SSRIs),lithium carbonate,carbamazepine,valproate sodium,cytosolic phospholipase A₂(cPLA₂),adenosine deaminase (ADAR₂),intracellular alkalinization

中图分类号:

薛占霞, 彭亮.情感性精神障碍疾病治疗药物的研究现状[J]. 神经药理学报, 2011, 1(3): 55-64.

XUE Zhan-xia, PENG Liang.Research Status of the Drugs Uesed in the Treatment of Affective Disorders Diseases[J]. ACTA NEUROPHARMACOLOGICA, 2011, 1(3): 55-64.

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情感性精神障碍疾病治疗药物的研究现状

Research Status of the Drugs Uesed in the Treatment of Affective Disorders Diseases

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