甲基苯丙胺药物治疗:需要重新关注甲基苯丙胺使用障碍期间和之后发生的复杂神经生物学变化。

IF 7.4 2区 医学 Q1 CLINICAL NEUROLOGY
CNS drugs Pub Date : 2025-11-01 Epub Date: 2025-09-14 DOI:10.1007/s40263-025-01214-3
Rebecca McKetin, Jee Hyun Kim, Alyna Turner, Michael Berk
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引用次数: 0

摘要

本文的目的是回顾与甲基苯丙胺使用障碍(MUD)相关的神经生物学变化,并考虑它们对开发有效药物治疗的影响。迫切需要新的药物治疗来解决在MUD期间和之后发生的复杂的神经生物学变化。目前的方法是模仿阿片类药物使用的维持疗法,特别是使用处方兴奋剂药物替代非法甲基苯丙胺。现有的证据表明,这些方法的效果有限,而且人们对毒性风险的担忧也降低了人们的热情。我们发现了一个超越维持治疗的机会,并考虑支持戒断开始和维持的替代药物治疗模式。在此过程中,我们强调了在停止使用甲基苯丙胺期间和之后发生的神经生物学变化的复杂性。我们确定需要药物治疗,以解决长期使用甲基苯丙胺造成的持久神经生物学变化,以提高治疗的参与和保留以及功能恢复,并降低复发风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Methamphetamine Pharmacotherapy: A Need to Re-focus on the Complex Neurobiological Changes that Occur Both During and After Methamphetamine Use Disorder.

The aim of this article is to review the neurobiological changes associated with methamphetamine use disorder (MUD) and consider what implications they have for the development of effective pharmacotherapies. Novel pharmacotherapies are urgently needed to address the complex neurobiological changes that occur both during and after MUD. Current approaches are modelled on maintenance therapies for opioid use, particularly with the use of prescription stimulant medications to substitute for illicit methamphetamine. Existing evidence suggests that these have limited effectiveness, and enthusiasm has been dampened by concerns about the risk of toxicity. We identify an opportunity to look beyond maintenance therapies and to consider alternative models of pharmacotherapy that support the initiation and maintenance of abstinence. In doing this, we highlight the complexity of the neurobiological changes that occur both during and after cessation of methamphetamine use. We identify a need for pharmacotherapies that can address the lasting neurobiological changes from long-term methamphetamine use to improve treatment engagement and retention as well as functional recovery and to reduce relapse risk.

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来源期刊
CNS drugs
CNS drugs 医学-精神病学
CiteScore
12.00
自引率
3.30%
发文量
82
审稿时长
6-12 weeks
期刊介绍: CNS Drugs promotes rational pharmacotherapy within the disciplines of clinical psychiatry and neurology. The Journal includes: - Overviews of contentious or emerging issues. - Comprehensive narrative reviews that provide an authoritative source of information on pharmacological approaches to managing neurological and psychiatric illnesses. - Systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. - Adis Drug Reviews of the properties and place in therapy of both newer and established drugs in neurology and psychiatry. - Original research articles reporting the results of well-designed studies with a strong link to clinical practice, such as clinical pharmacodynamic and pharmacokinetic studies, clinical trials, meta-analyses, outcomes research, and pharmacoeconomic and pharmacoepidemiological studies. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in CNS Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.
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