治疗神经精神疾病的精神活性物质。

IF 3.8 4区 医学 Q1 PSYCHIATRY
Zifan Zhen , Xueqiang Sun , Shiying Yuan , Jiancheng Zhang
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引用次数: 0

摘要

在当代精神医学领域,利用致幻剂、3,4-亚甲二氧基甲基苯丙胺(MDMA)和氯胺酮等精神活性物质治疗严重精神疾病取得了重大进展。本综述对这些物质进行了详细评估,重点关注其作用机制以及在受控环境下观察到的显著临床效果。麦角酰二乙胺和迷幻药等致幻剂主要以 5-HT2A 受体激动剂-2(5-HT2AR)为靶点,诱导感知和认知的实质性转变,从而促进深层次的心理反省和显著的治疗效果,尤其是对抑郁症和焦虑症患者而言。亚甲二氧基甲基苯丙胺(MDMA)可影响多种神经递质系统,包括 5-羟色胺(5-HT)、多巴胺和去甲肾上腺素,已被证明可有效缓解创伤后应激障碍的症状,增强患者在心理治疗过程中的情感投入和恢复能力。同时,氯胺酮作为一种谷氨酸受体拮抗剂,能迅速缓解抑郁症状,通过其速效抗抑郁特性为耐药性抑郁症患者提供了一条生命线。将这类药物纳入精神科治疗已显示出良好的效果,从根本上改变了对传统治疗方法无反应的患者的治疗格局。然而,这些药物的强效作用也要求在临床应用中采取谨慎的态度,确保仔细控制剂量、进行监测和风险管理,以防止潜在的滥用并减轻不良反应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Psychoactive substances for the treatment of neuropsychiatric disorders

In the contemporary landscape of psychiatric medicine, critical advancements have been noted in the utilization of psychoactive substances such as hallucinogens, 3,4-methylenedioxymethamphetamine (MDMA), and ketamine for the treatment of severe mental health disorders. This review provides a detailed evaluation of these substances, focusing on their mechanisms of action and the profound clinical outcomes observed in controlled environments. Hallucinogens like lysergic acid diethylamide and psilocybin primarily target the 5-HT2A receptor agonist-2 (5-HT2AR), inducing substantial perceptual and cognitive shifts that facilitate deep psychological introspection and significant therapeutic advances, particularly in patients suffering from depression and anxiety disorders. MDMA, influencing multiple neurotransmitter systems including 5-Hydroxytryptamine (5-HT), dopamine, and norepinephrine, has been demonstrated to effectively alleviate symptoms of post-traumatic stress disorder, enhancing patients' emotional engagement and resilience during psychotherapy. Meanwhile, ketamine, a glutamate receptor antagonist, rapidly alleviates depressive symptoms, offering a lifeline for individuals with treatment-resistant depression through its fast-acting antidepressant properties. The integration of these substances into psychiatric practice has shown promising results, fundamentally changing the therapeutic landscape for patients unresponsive to traditional treatment modalities. However, the potent effects of these agents also necessitate a cautious approach in clinical application, ensuring careful dosage control, monitoring, and risk management to prevent potential abuse and mitigate adverse effects.

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来源期刊
Asian journal of psychiatry
Asian journal of psychiatry Medicine-Psychiatry and Mental Health
CiteScore
12.70
自引率
5.30%
发文量
297
审稿时长
35 days
期刊介绍: The Asian Journal of Psychiatry serves as a comprehensive resource for psychiatrists, mental health clinicians, neurologists, physicians, mental health students, and policymakers. Its goal is to facilitate the exchange of research findings and clinical practices between Asia and the global community. The journal focuses on psychiatric research relevant to Asia, covering preclinical, clinical, service system, and policy development topics. It also highlights the socio-cultural diversity of the region in relation to mental health.
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