|国家科技期刊平台
首页|期刊导航|中国药理学与毒理学杂志|5-HT2A受体拮抗剂治疗神经精神疾病幻觉症状研究进展

5-HT2A受体拮抗剂治疗神经精神疾病幻觉症状研究进展OA北大核心CSTPCD

Progress of 5-HT2A receptor antagonists in treatment of hallucinatory symptoms induced by neuropsychiatric disorders

中文摘要英文摘要

帕金森病、阿尔茨海默病和精神分裂症等神经精神疾病在发展过程中会出现幻觉、妄想等精神病症状,这些症状发病率高、治愈难,严重影响患者生活质量.尽管经典抗精神病药物氯丙嗪、舒必利和奋乃静等通过拮抗多巴胺2型(D2)受体可治疗相关症状,但也会引发不可控的锥体外系反应和高泌乳素症等不良反应.近年来研究发现,奥氮平、氯氮平、利培酮和匹莫范色林等非经典抗精神病药物通过拮抗5-羟色胺2A(5-HT2A)受体或同时拮抗5-HT2A受体(强)和D2受体(弱)治疗神经精神疾病的幻觉症状.非临床研究结果表明,在多种因素诱导的幻觉模型上,非经典抗精神病药物均表现出良好的治疗作用;临床研究进一步证实,该类药物显著改善精神病症状(以幻觉和妄想为主),尤其是匹莫范色林,其对氯氮平、利培酮不敏感或耐受的患者仍能表现出良好的治疗效果.同时,非经典抗精神病药物不良反应的发生率和严重程度较低,总体耐受性较好.本文综述了5-HT2A受体拮抗剂改善神经精神疾病伴随的幻觉症状的研究进展,为设计开发新型神经精神疾病治疗药物提供参考.

Neuropsychiatric disorders such as Parkinson disease,Alzheimer disease,and schizo-phrenia may induce hallucinations,delusions,and other psychiatric symptoms during the course of disease development.These symptoms are highly prevalent and difficult to cure,and have a impact on the lives of patients.Classical antipsychotic drugs such as chlorpromazine,sulpiride and perphenazine can con-trol related symptoms,but they can also cause uncontrollable extrapyramidal system reactions and side effects such as hyperprolactinemia.In recent years,it has been found that non-classical antipsy-chotics such as olanzapine,clozapine,risperidone and pimovanserin can treat hallucinatory symptoms in neuropsychiatric disorders by antagonising the 5-hydroxytryptamine 2A(5-HT2A)receptor,or by antago-nising both the 5-HT2A receptor(strong)and the dopamine 2(D2)receptor(weak).In preclinical studies,non-classical antipsychotic drugs have shown great therapeutic effects against hallucination induced by multiple factors.Clinical studies have confirmed that these drugs improve psychotic symptoms(mainly hallucinations and delusions)significantly.In patients who are insensitive or tolerant to clozapine and risperidone,pimavanserin still shows therapeutic effects.At the same time,the incidence and severity of adverse reactions to non-classical antipsychotic drugs are reduced,and they are well tolerated.This article reviews the research progress in the role of 5-HT2A receptor antagonists in attenuating hallucino-genic symptoms so as to provide reference for the design and development of new therapeutic drugs.

赵玉;陈爱兵;俞纲;苏瑞斌

河北科技大学化学与制药工程学院,河北 石家庄 050018||军事科学院军事医学研究院国家安全特需药品全国重点实验室,神经精神药理学北京市重点实验室,北京 100850河北科技大学化学与制药工程学院,河北 石家庄 050018军事科学院军事医学研究院国家安全特需药品全国重点实验室,神经精神药理学北京市重点实验室,北京 100850

药学

5-HT2A受体拟精神病药物拮抗剂幻觉

5-HT2A receptorpsychotropic drugsantagonisthallucination

《中国药理学与毒理学杂志》 2024 (005)

384-391 / 8

10.3867/j.issn.1000-3002.2024.05.008

评论