The Future of Psychopharmacology of Depression
The Future of Psychopharmacology of Depression
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DOI：
10.4088/jcp.10m06223blu
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发表时间：
2010-08-01
影响因子：
5.3
通讯作者：
Fava, Maurizio
中科院分区：
文献类型：
--
作者：
Chang, Trina;Fava, Maurizio
目前批准的抑郁症药物疗法存在明显的局限性，包括它们基本上都是基于单胺的，具有适度的疗效和相对缓慢的疗效起效，并且遭受显著的耐受性问题，特别是长期耐受性问题，包括性功能障碍、体重增加和认知障碍。本文综述了一些最有前途的新机制，这些机制在美国或欧洲目前批准用于抑郁症的化合物中没有代表，可能代表抑郁症的精神药理学治疗的未来，可能解决市场上抗抑郁药的疗效和耐受性问题。这些潜在的抗抑郁治疗包括多模式多巴胺能药物、三重摄取抑制剂、基于神经激肽的新型治疗、多巴胺能治疗、基于烟碱受体的治疗、基于神经发生的治疗和抗糖皮质激素治疗。其中一些机制在药物开发方面似乎比其他机制更先进，但它们都有助于全球努力开发更有效和更耐受的重度抑郁症治疗方法。J Clin Psychiatry 2010;71（8）：971-975（C）Copyright 2010 Physicians Postgraduate Press，Inc.
There are clear limitations to the currently approved pharmacotherapies of depression, including the fact that they are all essentially monoamine-based, have modest efficacy and a relatively slow onset of efficacy, and suffer from significant tolerability issues, particularly in the long term, including sexual dysfunction, weight gain, and cognitive impairments. This article reviews some of the most promising novel mechanisms that are not represented in compounds currently approved for depression in either the United States or Europe and that May represent the future of the psychopharmacologic treatment of depression, potentially addressing some of the efficacy and tolerability issues of antidepressants on the market. These potential antidepressant treatments include the multimodal serotonergic agents, the triple uptake inhibitors, the neurokinin-based novel therapies, the glutamatergic treatments, the nicotinic receptor-based treatments, the neurogenesis-based treatments, and antiglucocorticoid therapies. Some of these mechanisms appear to be more advanced in terms of drug development than others, but they all contribute to the global effort to develop more effective and better tolerated treatments for major depressive disorder. J Clin Psychiatry 2010;71(8):971-975 (C) Copyright 2010 Physicians Postgraduate Press, Inc.