Depression and stimulant dependence: neurobiology and pharmacotherapy.

Depression and stimulant dependence: neurobiology and pharmacotherapy.
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抑郁症和兴奋剂依赖:神经生物学和药物治疗。

DOI:
10.1097/00005053-199812000-00001
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发表时间:
1998
期刊:
The Journal of nervous and mental disease
影响因子:
--
通讯作者:
Koob,GF
Koob,GF
中科院分区:
--
文献类型:
--
作者:
Kosten,TR;Markou,A;Koob,GF

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兴奋剂依赖者的抑郁症发病率大大高于社区发病率。此外,抑郁症状被认为是兴奋剂戒断的主要组成部分。这些疾病的合并症可能反映了5-羟色胺、多巴胺和肽系统(如促肾上腺皮质激素释放因子(CRF)和神经肽Y(NPY))功能的共同神经化学改变。这些改变在患者、抑郁症和兴奋剂依赖的动物模型中观察到,特别是在边缘脑结构中。这种共同的神经生物学似乎并不是由显著的共同遗传性或遗传连锁引起的;兴奋剂可能会诱导神经生物学的变化,这些变化与抑郁症中发现的变化相似,这些变化可能提供一个治疗靶点。患有抑郁症的兴奋剂依赖患者可能是抗抑郁药试验的一个特定亚群,他们在接受抗抑郁药治疗时可能会减少兴奋剂滥用。然而,同时依赖酒精或阿片类药物可能会影响这种反应,抗抑郁药似乎是更有效的抑郁症的兴奋剂和阿片类药物的依赖比兴奋剂和酒精的依赖。
Depressive disorder rates in stimulant-dependent individuals are substantially higher than community rates. Further, depressive symptoms are considered a major component of stimulant withdrawal. The comorbidity of these disorders may reflect shared neurochemical alterations in the function of serotonin, dopamine, and peptide systems, such as corticotropin releasing factor (CRF) and neuropeptide Y (NPY). These alterations are observed in patients, and in animal models of depression and stimulant dependence, particularly in limbic brain structures. This shared neurobiology does not seem to result from significant shared heritability or genetic linkage; stimulants may induce changes in neurobiology that are similar to those found in depression, and these changes might provide a therapeutic target. Stimulant-dependent patients with a depressive disorder may be a specific subpopulation for antidepressant trials, and they might reduce their stimulant abuse when treated with antidepressants. Nevertheless, concomitant dependence on alcohol or opioids may influence this response, and antidepressants appear to be more effective for depression in combined stimulant and opioid dependence than in combined stimulant and alcohol dependence.
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