Glutamatergic medications for the treatment of drug and behavioral addictions.
Glutamatergic medications for the treatment of drug and behavioral addictions.
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用于治疗药物和行为成瘾的谷氨酸能药。
DOI：
10.1016/j.pbb.2011.04.015
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发表时间：
2012-02
期刊：
影响因子：
--
通讯作者：
Malcolm RJ
中科院分区：
文献类型：
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作者：
Olive MF;Cleva RM;Kalivas PW;Malcolm RJ
从历史上看，大多数治疗成瘾性疾病的药理学方法要么利用基于替代的方法（即尼古丁替代或阿片维持），要么针对单胺能或内源性阿片能神经递质系统。然而，已经积累的大量证据表明，作用于谷氨酸能传递的配体在治疗药物成瘾以及各种行为成瘾（如病理性赌博）方面也具有潜在的效用。本综述的目的是总结目前已批准或正在研究批准的用于治疗成瘾性疾病的谷氨酸能药物的药理作用机制和一般临床疗效。将讨论对谷氨酸能传递有影响的药物包括阿坎前列酸、n -乙酰半胱氨酸、d -环丝氨酸、加巴喷丁、拉莫三嗪、美金刚、莫达非尼和托吡酯。我们得出的结论是，谷氨酸能神经传递的操纵是相对年轻的，但有希望的途径，为改善治疗药物和行为成瘾的药物的发展。
Historically, most pharmacological approaches to the treatment of addictive disorders have utilized either substitution-based methods (i.e., nicotine replacement or opioid maintenance) or have targeted monoaminergic or endogenous opioidergic neurotransmitter systems. However, substantial evidence has accumulated indicating that ligands acting on glutamatergic transmission are also of potential utility in the treatment of drug addiction, as well as various behavioral addictions such as pathological gambling. The purpose of this review is to summarize the pharmacological mechanisms of action and general clinical efficacy of glutamatergic medications that are currently approved or are being investigated for approval for the treatment of addictive disorders. Medications with effects on glutamatergic transmission that will be discussed include acamprosate, N-acetylcysteine, D-cycloserine, gabapentin, lamotrigine, memantine, modafinil, and topiramate. We conclude that manipulation of glutamatergic neurotransmission is relatively young but promising avenue for the development of improved therapeutic agents for the treatment of drug and behavioral addictions.