Hallucinogens

致幻剂
  • 文章类型: Systematic Review
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  • 文章类型: Journal Article
    背景:异常神经元Sigma-1受体(Sig-1r)介导的内质网(ER)-线粒体信号在阿尔茨海默病(AD)的神经元细胞病理学中起关键作用。自然的迷幻N,N-二甲基色胺(DMT)是Sig-1r激动剂,其可通过保护神经元ER-线粒体相互作用而具有抗AD潜能。
    方法:3xTG-AD转基因小鼠给予慢性DMT(2mg/kg)3周,然后进行水迷宫试验。测定小鼠脑中的Aβ积累。测试DMT处理后的Sig-1r水平。检查了DMT对ER-线粒体接触位点和多个线粒体相关膜(MAM)相关蛋白的影响。还评估了DMT对ER和线粒体之间的钙转运和线粒体功能的影响。
    结果:慢性DMT(2mg/kg)可明显减轻3×TG-AD小鼠的认知障碍。并行,它大大减少了海马和前额叶皮层中Aβ的积累。DMT恢复了3×TG-AD转基因小鼠的降低的Sig-1r水平。致幻剂可恢复3×TG-AD小鼠脑中多种MAM相关蛋白的表达。DMT还在体外和体内病理情况下阻止了两种细胞器之间的物理接触和钙动力。DMT在AD的体外模型中调节氧化磷酸化(OXPHOS)和ATP合酶。
    结论:DMT的抗AD作用与其通过激活Sig-1r保护神经元ER-线粒体串扰有关。DMT具有作为抗AD的新型预防和治疗剂的潜力。
    BACKGROUND: Aberrant neuronal Sigma-1 receptor (Sig-1r)-mediated endoplasmic reticulum (ER)- mitochondria signaling plays a key role in the neuronal cytopathology of Alzheimer\'s disease (AD). The natural psychedelic N, N-dimethyltryptamine (DMT) is a Sig-1r agonist that may have the anti-AD potential through protecting neuronal ER-mitochondrial interplay.
    METHODS: 3×TG-AD transgenic mice were administered with chronic DMT (2 mg/kg) for 3 weeks and then performed water maze test. The Aβ accumulation in the mice brain were determined. The Sig-1r level upon DMT treatment was tested. The effect of DMT on the ER-mitochondrial contacts site and multiple mitochondria-associated membrane (MAM)-associated proteins were examined. The effect of DMT on calcium transport between ER and mitochondria and the mitochondrial function were also evaluated.
    RESULTS: chronic DMT (2 mg/kg) markedly alleviated cognitive impairment of 3×TG-AD mice. In parallel, it largely diminished Aβ accumulation in the hippocampus and prefrontal cortex. DMT restored the decreased Sig-1r levels of 3×TG-AD transgenic mice. The hallucinogen reinstated the expression of multiple MAM-associated proteins in the brain of 3×TG-AD mice. DMT also prevented physical contact and calcium dynamic between the two organelles in in vitro and in vivo pathological circumstances. DMT modulated oxidative phosphorylation (OXPHOS) and ATP synthase in the in vitro model of AD.
    CONCLUSIONS: The anti-AD effects of DMT are associated with its protection of neuronal ER-mitochondria crosstalk via the activation of Sig-1r. DMT has the potential to serve as a novel preventive and therapeutic agent against AD.
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  • 文章类型: Journal Article
    强烈影响人类和动物的大脑和行为,致幻药物最近已成为精神药物治疗中潜在的有前途的药物。补充实验室啮齿动物,斑马鱼(Daniorerio)是筛选神经活性药物的强大模型生物,包括致幻剂.这里,我们测试了四种在苯乙胺部分和-F中具有2,4-和3,4-二甲氧基取代的新型N-苄基-2-苯乙胺(NBPEA)衍生物,-Cl,和N-苄基部分的苯环的邻位中的-OCF3取代(34H-NBF,34H-NBCl,24H-NBOMe(F),和34H-NBOMe(F)),评估成年斑马鱼慢性治疗14天后的行为和神经化学效应。虽然新的坦克测试行为数据表明24H-NBOMe(F)和34H-NBOMe(F)的抗焦虑作用,神经化学分析显示所有四种药物都减少了大脑去甲肾上腺素,和(34H-NBCl除外)-降低多巴胺和5-羟色胺水平。我们还发现,所有三种脑单胺的周转率均降低,但其各自代谢物的水平未改变。总的来说,这些发现进一步加深了我们对慢性给药的新型NBPEAs的复杂中枢行为和神经化学效应的理解,并突出了斑马鱼作为小精神活性分子临床前筛查模型的潜力.
    Potently affecting human and animal brain and behavior, hallucinogenic drugs have recently emerged as potentially promising agents in psychopharmacotherapy. Complementing laboratory rodents, the zebrafish (Danio rerio) is a powerful model organism for screening neuroactive drugs, including hallucinogens. Here, we tested four novel N-benzyl-2-phenylethylamine (NBPEA) derivatives with 2,4- and 3,4-dimethoxy substitutions in the phenethylamine moiety and the -F, -Cl, and -OCF3 substitutions in the ortho position of the phenyl ring of the N-benzyl moiety (34H-NBF, 34H-NBCl, 24H-NBOMe(F), and 34H-NBOMe(F)), assessing their behavioral and neurochemical effects following chronic 14 day treatment in adult zebrafish. While the novel tank test behavioral data indicate anxiolytic-like effects of 24H-NBOMe(F) and 34H-NBOMe(F), neurochemical analyses reveal reduced brain norepinephrine by all four drugs, and (except 34H-NBCl) - reduced dopamine and serotonin levels. We also found reduced turnover rates for all three brain monoamines but unaltered levels of their respective metabolites. Collectively, these findings further our understanding of complex central behavioral and neurochemical effects of chronically administered novel NBPEAs and highlight the potential of zebrafish as a model for preclinical screening of small psychoactive molecules.
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  • 文章类型: Meta-Analysis
    我们旨在系统地回顾和荟萃分析迷幻药的有效性和安全性[psilocybin,ayahuasca(活性成分DMT),LSD和MDMA]治疗各种精神障碍的症状。WebofScience,Embase,EBSCO,截至2024年2月,PubMed进行了搜索,最终收录了126篇文章。结果表明,psilocybin有最多的文章治疗情绪障碍(N=28),其次是ayahuasca(N=7)和LSD(N=6)。总的来说,迷幻药对抑郁症和焦虑症等精神障碍有治疗作用。具体来说,psilocybin(Hedges\'g=-1.49,95%CI[-1.67,-1.30])在四种迷幻药中显示出最强的治疗效果,其次是ayahuasca(对冲=-1.34,95%CI[-1.86,-0.82]),MDMA(对冲=-0.83,95%CI[-1.33,-0.32]),和LSD(对冲=-0.65,95%CI[-1.03,-0.27])。少量证据也支持迷幻药改善烟草成瘾,饮食失调,睡眠障碍,边缘性人格障碍,强迫症,和身体畸形。迷幻药最常见的不良事件是头痛。近三分之一的文章报告说,没有参与者报告持续的不良反应。我们的分析表明,迷幻药可以减少负面情绪,并对其他精神障碍有潜在疗效,如物质使用障碍和创伤后应激障碍。
    We aim to systematically review and meta-analyze the effectiveness and safety of psychedelics [psilocybin, ayahuasca (active component DMT), LSD and MDMA] in treating symptoms of various mental disorders. Web of Science, Embase, EBSCO, and PubMed were searched up to February 2024 and 126 articles were finally included. Results showed that psilocybin has the largest number of articles on treating mood disorders (N = 28), followed by ayahuasca (N = 7) and LSD (N = 6). Overall, psychedelics have therapeutic effects on mental disorders such as depression and anxiety. Specifically, psilocybin (Hedges\' g = -1.49, 95% CI [-1.67, -1.30]) showed the strongest therapeutic effect among four psychedelics, followed by ayahuasca (Hedges\' g = -1.34, 95% CI [-1.86, -0.82]), MDMA (Hedges\' g = -0.83, 95% CI [-1.33, -0.32]), and LSD (Hedges\' g = -0.65, 95% CI [-1.03, -0.27]). A small amount of evidence also supports psychedelics improving tobacco addiction, eating disorders, sleep disorders, borderline personality disorder, obsessive-compulsive disorder, and body dysmorphic disorder. The most common adverse event with psychedelics was headache. Nearly a third of the articles reported that no participants reported lasting adverse effects. Our analyses suggest that psychedelics reduce negative mood, and have potential efficacy in other mental disorders, such as substance-use disorders and PTSD.
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  • 文章类型: Journal Article
    近年来,基于结构修饰合成的新精神活性物质的类型和数量迅速增加,对临床和法医实验室构成了巨大挑战。苯乙胺的N-苄基衍生物,25B-NBOH,25E-NBOH,25H-NBOH,和25iP-NBOMe已经开始流入黑市,并造成了几起中毒事件,甚至致命的案件。本研究旨在通过检测母体药物及其代谢产物来扩大生物基质中的检测窗口,避免假阴性结果,为法医和急诊案件中非法药物和代谢产物的同时测定提供基础数据。为了便于比较代谢特征,我们把这四种化合物分成两类,25X-NBOH和25X-NBOMe。通过将10mgmL-1的合并人肝微粒体与共底物在37℃下孵育180分钟,研究了这四种化合物的体外I期和II期代谢。然后使用超高效液相色谱-四极杆/静电fi场轨道阱质谱分析反应混合物。总的来说,获得了四个化合物的70个代谢物。主要的生物转化是O-去甲基化,羟基化,脱氢,N-去羟基苄基,N-去甲氧基苄基,氧化转化为酮和羧酸盐,葡糖醛酸化,以及它们的组合反应。我们推荐具有高峰面积比的主要代谢物作为生物标志物,B2-1(56.61%),25B-NBOH的B2-2(17.43%)和B6(17.78%),E2-1(42.81%),25E-NBOH的E2-2(34.90%)和E8-2(10.18%),H5(49.28%),H2-1(21.54%),25H-NBH的H1(18.37%),P3-1(10.94%),P3-2(33.18%),25iP-NBOMe的P3-3(14.85%)和P12-2(23.00%)。这是一项详细评估其代谢特征的研究。苯乙胺的N-苄基衍生物的比较分析为阐明其药理学和毒性提供了基础数据。及时分析具有滥用潜力的化合物的代谢概况将有助于早期制定监管措施。
    The types and quantities of new psychoactive substances synthesized based on structural modifications have increased rapidly in recent years and pose a great challenge to clinical and forensic laboratories. N-benzyl derivatives of phenethylamines, 25B-NBOH, 25E-NBOH, 25H-NBOH, and 25iP-NBOMe have begun to flow into the black market and have caused several poisoning cases and even fatal cases. The aim of this study was to avoid false negative results by detecting the parent drug and its metabolites to extend the detection window in biological matrices and provide basic data for the simultaneous determination of illegal drugs and metabolites in forensic and emergency cases. To facilitate the comparison of metabolic characteristics, we divided the four compounds into two groups of types, 25X-NBOH and 25X-NBOMe. The in vitro phase I and phase II metabolism of these four compounds was investigated by incubating 10 mg mL-1 pooled human liver microsomes with co-substrates for 180 min at 37 ℃, and then analyzing the reaction mixture using ultrahigh-performance liquid chromatography-quadrupole/electrostatic field orbitrap mass spectrometry. In total, 70 metabolites were obtained for the four compounds. The major biotransformations were O-demethylation, hydroxylation, dehydrogenation, N-dehydroxybenzyl, N-demethoxybenzyl, oxidate transformation to ketone and carboxylate, glucuronidation, and their combination reactions. We recommended the major metabolites with high peak area ratio as biomarkers, B2-1 (56.61%), B2-2 (17.43%) and B6 (17.78%) for 25B-NBOH, E2-1 (42.81%), E2-2 (34.90%) and E8-2 (10.18%) for 25E-NBOH, H5 (49.28%), H2-1 (21.54%), and H1 (18.37%) for 25H-NBOH, P3-1 (10.94%), P3-2 (33.18%), P3-3 (14.85%) and P12-2 (23.00%) for 25iP-NBOMe. This is a study to evaluate their metabolic characteristics in detail. Comparative analysis of the N-benzyl derivatives of phenethylamines provided basic data for elucidating their pharmacology and toxicity. Timely analysis of the metabolic profiles of compounds with abuse potential will facilitate the early development of regulatory measures.
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  • 文章类型: Journal Article
    迷幻药构成一组通过激活5-羟色胺2A受体(5-HT2AR)诱导致幻作用的精神活性化合物。临床试验表明,像psilocybin这样的传统迷幻物质是一类速效和持久的抗抑郁药。然而,迫切需要合理设计的具有最佳药理学特征的5-HT2AR激动剂,以充分揭示这些激动剂的治疗潜力,并确定没有致幻作用的更安全的候选药物.本观点概述了现有5-HT2AR激动剂基于其化学分类的结构-活性关系,并讨论了在结构水平上理解其分子药理学的最新进展。迷幻药在抑郁症治疗中令人鼓舞的临床结果引发了药物发现的努力,旨在开发具有改善亚型选择性和信号偏向特性的新型5-HT2AR激动剂。可以作为更安全和潜在非致幻的抗抑郁药。通过利用基于结构的方法和功能选择性指导的筛选,可以显着加快这些努力。
    Psychedelics make up a group of psychoactive compounds that induce hallucinogenic effects by activating the serotonin 2A receptor (5-HT2AR). Clinical trials have demonstrated the traditional psychedelic substances like psilocybin as a class of rapid-acting and long-lasting antidepressants. However, there is a pressing need for rationally designed 5-HT2AR agonists that possess optimal pharmacological profiles in order to fully reveal the therapeutic potential of these agonists and identify safer drug candidates devoid of hallucinogenic effects. This Perspective provides an overview of the structure-activity relationships of existing 5-HT2AR agonists based on their chemical classifications and discusses recent advancements in understanding their molecular pharmacology at a structural level. The encouraging clinical outcomes of psychedelics in depression treatment have sparked drug discovery endeavors aimed at developing novel 5-HT2AR agonists with improved subtype selectivity and signaling bias properties, which could serve as safer and potentially nonhallucinogenic antidepressants. These efforts can be significantly expedited through the utilization of structure-based methods and functional selectivity-directed screening.
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  • 文章类型: Journal Article
    背景:先前的研究强调了大麻使用与糖尿病及其并发症之间的关联;然而,因果关系仍然模棱两可。
    方法:单变量孟德尔随机化(MR),多变量MR,调解先生,和连锁不平衡评分(LDSC)分析,以评估大麻使用与12种糖尿病表型之间的因果关系。来自全基因组关联研究的终生大麻使用(N=184,765)和大麻使用障碍(CUD)(N=374,287)的汇总统计数据。使用的主要方法是逆方差加权(IVW)。一系列的灵敏度分析确保了结果的鲁棒性。
    结果:LDSC分析显示CUD和T2DM之间存在显著的遗传相关性,以及终生使用大麻和四种糖尿病表型之间(P<0.05)。通过错误发现率(FDR)校正后,主要IVW分析表明,遗传预测的CUD与糖尿病性低血糖(OR=1.11,95%CI1.04-1.20,P=0.003,PFDR=0.04)和增生性糖尿病性视网膜病变(PDR)(OR=1.12,95%CI1.04-1.19,P=4.89×10-4,PFDR=0.01)的风险呈正相关.此外,提示证据表明CUD与糖尿病肾病的风险增加,1型糖尿病(T1DM),糖尿病视网膜病变,T1DM与糖尿病酮症酸中毒相关(P<0.05,PFDR>0.05)。终生使用大麻与糖尿病表型之间未检测到因果关系(P>0.05和PFDR>0.05)。多变量和中介MR分析显示,糖化血红蛋白A1c部分介导了CUD对PDR和糖尿病性低血糖的因果关系。
    结论:这项MR研究表明,CUD可能在几种糖尿病疾病表型中具有因果关系。
    BACKGROUND: Previous studies have highlighted the association between cannabis use and diabetes and its complications; however, the causality remains ambiguous.
    METHODS: Univariate Mendelian randomization (MR), multivariate MR, mediation MR, and linkage disequilibrium score (LDSC) analysis to assess the causal relationship between cannabis use and 12 diabetic phenotypes. Summary statistics for lifetime cannabis use (N = 184,765) and cannabis use disorder (CUD) (N = 374,287) from genome-wide association studies. The primary method used was inverse-variance-weighted (IVW). A range of sensitivity analyses ensured the robustness of the results.
    RESULTS: LDSC analysis revealed a significant genetic correlation between CUD and T2DM, as well as between lifetime cannabis use and four diabetic phenotypes (P < 0.05). After correction by false discovery rate (FDR), the primary IVW analysis indicates that the genetically predicted CUD is positively associated with the risk of diabetic hypoglycemia (OR = 1.11, 95% CI 1.04-1.20, P = 0.003, PFDR = 0.04) and proliferative diabetic retinopathy (PDR) (OR = 1.12, 95% CI 1.04-1.19, P = 4.89×10-4, PFDR =0.01). Additionally, suggestive evidence links CUD with increased risks of diabetic nephropathy, type 1 diabetes mellitus (T1DM), diabetic retinopathy, and T1DM associated with diabetic ketoacidosis (P < 0.05 & PFDR > 0.05). No causal relationship was detected between lifetime cannabis use and diabetic phenotypes (P > 0.05 & PFDR > 0.05). Multivariable and mediation MR analyses revealed that glycated hemoglobin A1c partially mediates the causal effect of CUD on PDR and diabetic hypoglycemia.
    CONCLUSIONS: This MR study suggests that CUD may have a causal role in several diabetic disease phenotypes.
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  • 文章类型: Journal Article
    作为5-羟色胺2A受体(5-HT2AR)激动剂的麻醉剂氯胺酮和经典迷幻药在难治性抑郁症患者中表现出快速和持续的抗抑郁作用。据报道,新的抗抑郁药阿氯胺酮可在脂多糖(LPS)处理的小鼠和暴露于慢性抑制应激(CRS)的小鼠中引起持久的预防作用。然而,没有研究比较DOI的预防作用(2,5-二甲氧基-4-碘苯丙胺:一种具有强效5-HT2AR激动作用的致幻迷幻药),利苏利德(具有5-HT2AR和5-HT1AR激动作用的非致幻迷幻类似物),和阿氯胺酮对小鼠抑郁样行为的影响。盐水(10ml/kg),DOI(2.0或4.0mg/kg),利苏利特(1.0或2.0mg/kg),在施用LPS(1.0mg/kg)前6天,向雄性小鼠腹膜内(i.p.)施用阿氯胺酮(10mg/kg)。用阿克他命预处理,但不是DOI和利苏利德,显著改善体重减轻,脾肿大,强迫游泳试验(FST)的不动时间增加,LPS处理的小鼠前额叶皮质(PFC)中PSD-95的表达降低。在另一个测试中,雄性小鼠在CRS前一天(7天)接受相同的治疗。用阿克他命预处理,但不是DOI和利苏利德,显着改善了FST固定时间的增加,蔗糖偏好测试中降低的蔗糖偏好,CRS暴露小鼠PFC中PSD-95的表达降低。这些发现表明,不像阿氯胺酮,在抑郁症小鼠模型中,DOI和利苏利特均未表现出长效预防作用.
    Anesthetic ketamine and classical psychedelics that act as 5-hydroxytryptamine-2A receptor (5-HT2AR) agonists demonstrated rapid and sustained antidepressant actions in patients with treatment-resistant depression. The new antidepressant arketamine is reported to cause long-lasting prophylactic effects in lipopolysaccharide (LPS)-treated mice and mice exposed to chronic restrain stress (CRS). However, no study has compared the prophylactic effects of DOI (2,5-dimethoxy-4-iodoamphetamine: a hallucinogenic psychedelic drug with potent 5-HT2AR agonism), lisuride (non-hallucinogenic psychedelic analog with 5-HT2AR and 5-HT1AR agonism), and arketamine on depression-like behaviors in mice. Saline (10 ml/kg), DOI (2.0 or 4.0 mg/kg), lisuride (1.0 or 2.0 mg/kg), or arketamine (10 mg/kg) was administered intraperitoneally (i.p.) to male mice 6 days before administration of LPS (1.0 mg/kg). Pretreatment with aketamine, but not DOI and lisuride, significantly ameliorated body weight loss, splenomegaly, the increased immobility time of forced swimming test (FST), and the decreased expression of PSD-95 in the prefrontal cortex (PFC) of LPS-treated mice. In another test, male mice received the same treatment one day before CRS (7 days). Pretreatment with aketamine, but not DOI and lisuride, significantly ameliorated the increased FST immobility time, the reduced sucrose preference in the sucrose preference test, and the decreased expression of PSD-95 in the PFC of CRS-exposed mice. These findings suggest that, unlike to arketamine, both DOI and lisuride did not exhibit long-lasting prophylactic effects in mouse models of depression.
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  • 文章类型: Review
    目的:本研究调查了植物化学治疗创伤后应激障碍(PTSD)的研究趋势。
    方法:使用搜索词“植物化学物质”和“PTSD”搜索WebofScience数据库(2007-2022),\"和相关文献进行了汇编。进行网络聚类共现分析和定性叙事综述。
    结果:对已发表研究的分析中包含了三百零一篇文章,自2015年以来,这一数字激增,近一半的相关文章来自北美。该类别以神经科学和神经病学为主,有两本日记,成瘾行为与药物和酒精依赖,发表关于这些主题的论文数量最多。大多数研究集中在对PTSD的迷幻干预上。三个时间表显示了“物质使用/大麻滥用”和“迷幻药物/药用大麻”之间的“潮起潮落”现象。“其他植物化学物质占研究的一小部分,专注于神经类固醇周转等主题,血清素水平,和脑源性神经营养因子的表达。
    结论:关于植物化学物质和创伤后应激障碍的研究在各个国家/地区分布不均,学科,和期刊。自2015年以来,研究范式转变为构成迄今为止迷幻研究的主流,导致植物活性成分和分子机制的探索。其他研究集中在抗氧化应激和抗炎。请引用这篇文章:高B,曲YC,蔡MY,张YY,LuHT,李HX,唐YX,ShenH.创伤后应激障碍的植物化学干预:使用CiteSpace进行集群共现网络分析。JIntegrMed。2023年;Epub领先于印刷。
    This study investigated trends in the study of phytochemical treatment of post-traumatic stress disorder (PTSD).
    The Web of Science database (2007-2022) was searched using the search terms \"phytochemicals\" and \"PTSD,\" and relevant literature was compiled. Network clustering co-occurrence analysis and qualitative narrative review were conducted.
    Three hundred and one articles were included in the analysis of published research, which has surged since 2015 with nearly half of all relevant articles coming from North America. The category is dominated by neuroscience and neurology, with two journals, Addictive Behaviors and Drug and Alcohol Dependence, publishing the greatest number of papers on these topics. Most studies focused on psychedelic intervention for PTSD. Three timelines show an \"ebb and flow\" phenomenon between \"substance use/marijuana abuse\" and \"psychedelic medicine/medicinal cannabis.\" Other phytochemicals account for a small proportion of the research and focus on topics like neurosteroid turnover, serotonin levels, and brain-derived neurotrophic factor expression.
    Research on phytochemicals and PTSD is unevenly distributed across countries/regions, disciplines, and journals. Since 2015, the research paradigm shifted to constitute the mainstream of psychedelic research thus far, leading to the exploration of botanical active ingredients and molecular mechanisms. Other studies focus on anti-oxidative stress and anti-inflammation. Please cite this article as: Gao B, Qu YC, Cai MY, Zhang YY, Lu HT, Li HX, Tang YX, Shen H. Phytochemical interventions for post-traumatic stress disorder: A cluster co-occurrence network analysis using CiteSpace. J Integr Med. 2023; 21(4):385-396.
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  • 文章类型: Journal Article
    重度抑郁症(MDD)是一种慢性复发性精神疾病。传统的抗抑郁药通常需要连续给药数周才能发挥临床上显著的治疗效果。而约三分之二的患者容易症状复发或在抗抑郁治疗中完全无效。最近成功的N-甲基-D-天冬氨酸(NMDA)受体拮抗剂氯胺酮作为一种快速作用的抗抑郁药,推动了对抗抑郁药作用机制的广泛研究。尤其是它在突触靶标中的作用。研究表明,氯胺酮的抗抑郁作用机制不仅限于突触后NMDA受体或GABA中间神经元的拮抗作用。氯胺酮通过影响α-氨基-3-羟基-5-甲基-4-异恶唑-丙酸受体产生强大而快速的抗抑郁作用,腺苷A1受体,和L型钙通道,在突触中。更有趣的是,在抑郁小鼠模型和临床研究中,5-HT2A受体激动剂psilocybin具有快速抗抑郁作用的潜力.本文重点介绍了新兴的快速作用抗抑郁药物如氯胺酮和致幻剂的新药理靶点研究(例如,psilocybin)并简要讨论了抗抑郁药新靶点的可能策略,以期阐明未来抗抑郁药研究的方向。
    Major depressive disorder (MDD) is a chronic relapsing psychiatric disorder. Conventional antidepressants usually require several weeks of continuous administration to exert clinically significant therapeutic effects, while about two-thirds of the patients are prone to relapse of symptoms or are completely ineffective in antidepressant treatment. The recent success of the N-methyl-D-aspartic acid (NMDA) receptor antagonist ketamine as a rapid-acting antidepressant has propelled extensive research on the action mechanism of antidepressants, especially in relation to its role in synaptic targets. Studies have revealed that the mechanism of antidepressant action of ketamine is not limited to antagonism of postsynaptic NMDA receptors or GABA interneurons. Ketamine produces powerful and rapid antidepressant effects by affecting α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptors, adenosine A1 receptors, and the L-type calcium channels, among others in the synapse. More interestingly, the 5-HT2A receptor agonist psilocybin has demonstrated potential for rapid antidepressant effects in depressed mouse models and clinical studies. This article focuses on a review of new pharmacological target studies of emerging rapid-acting antidepressant drugs such as ketamine and hallucinogens (e.g., psilocybin) and briefly discusses the possible strategies for new targets of antidepressants, with a view to shed light on the direction of future antidepressant research.
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