Antipsychotic Drugs: The Antithesis to Neurorehabilitation in Models of Pre-Clinical Traumatic Brain Injury.
Antipsychotic Drugs: The Antithesis to Neurorehabilitation in Models of Pre-Clinical Traumatic Brain Injury.
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DOI：
10.1089/neur.2023.0082
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发表时间：
2023
影响因子：
2.4
通讯作者：
Kline, Anthony E.
中科院分区：
文献类型：
--
作者：
Race, Nicholas S.;Moschonas, Eleni H.;Cheng, Jeffrey P.;Bondi, Corina O.;Kline, Anthony E.
关键词：
全世界每年报告6900万例创伤性脑损伤（TBI），其中近300万例发生在美国。除了神经行为和认知缺陷外，TBI还诱导其他适应不良行为，如激动和攻击，必须对这些行为进行管理，以安全，准确地评估和有效地治疗患者。在TBI中使用抗精神病药物（APD）得到了一些专家指南的支持，这表明它们是用于管理激越的药理学设备的重要组成部分。尽管TBI后APD具有优势，但由于缺乏现成的更新纲要，在临床决策过程中可能无法充分认识到其显著的缺点。因此，本综述的目的是整合现有的研究结果，并介绍APD在TBI临床前模型中的应用现状。通过PubMed和匹兹堡大学图书馆系统搜索策略确定了所讨论的研究，并显示APD，特别是具有多巴胺2（D2）受体拮抗作用的APD，通常会损害两性啮齿动物的恢复过程，并且在某些情况下，会减弱神经康复的潜在益处。我们认为，通过对临床前TBI + APD模型的详尽审查所代表的结果汇编，可以作为指导重症监护临床医生和理疗师考虑将APD用于表现出激越的患者的明智决策的方便来源。
Sixty-nine million traumatic brain injuries (TBIs) are reported worldwide each year, and, of those, close to 3 million occur in the United States. In addition to neurobehavioral and cognitive deficits, TBI induces other maladaptive behaviors, such as agitation and aggression, which must be managed for safe, accurate assessment and effective treatment of the patient. The use of antipsychotic drugs (APDs) in TBI is supported by some expert guidelines, which suggests that they are an important part of the pharmacological armamentarium to be used in the management of agitation. Despite the advantages of APDs after TBI, there are significant disadvantages that may not be fully appreciated clinically during decision making because of the lack of a readily available updated compendium. Hence, the aim of this review is to integrate the existing findings and present the current state of APD use in pre-clinical models of TBI. The studies discussed were identified through PubMed and the University of Pittsburgh Library System search strategies and reveal that APDs, particularly those with dopamine2 (D2) receptor antagonism, generally impair the recovery process in rodents of both sexes and, in some instances, attenuate the potential benefits of neurorehabilitation. We believe that the compilation of findings represented by this exhaustive review of pre-clinical TBI + APD models can serve as a convenient source for guiding informed decisions by critical care clinicians and physiatrists contemplating APD use for patients exhibiting agitation.
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DOI：
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发表时间：
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影响因子：
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