Introduction to Neurotherapeutics and Neuropsychopharmacology

J. Cummings
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Abstract

In recent years there has been tremendous progress in advancing new treatments for neurologic and psychiatric illnesses. New agents have emerged for the treatment of Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, epilepsy, migraine, schizophrenia, bipolar illness, depression, and substance abuse disorders. Advances in understanding of basic pathophysiology and molecular biology of brain disorders have led to increasingly sophisticated target identification that guides drug development. Advances in the basic neuroscience and disease mechanisms have been particularly obvious in the neurologic disorders where there is an ever improving understanding of the underlying mechanisms of brain function and brain disease. Progress in neurotherapeutics has occurred in concert with progress in basic science methodologies, neuroimaging, clinical trial design, and trial analysis. There is an increasing enthusiasm for clinical trials that provide highly credible data with which to guide evidence-based medicine. The United States Food and Drug Administration (US FDA) requires a close link between the clinical trial population tested and the specific indication for which the agent will be approved. This contributes to the proliferation of clinical trials, as industry sponsors of trials seek to expand the populations for which their products are indicated. An increasing number of patients and physicians are involved in clinical trials. Advancing clinical trial methodology has itself become a major endeavor.
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神经治疗学和神经精神药理学导论
近年来,在推进神经和精神疾病的新疗法方面取得了巨大进展。治疗阿尔茨海默病、帕金森病、多发性硬化症、癫痫、偏头痛、精神分裂症、躁郁症、抑郁症和药物滥用障碍的新药物已经出现。对脑部疾病的基本病理生理学和分子生物学的理解的进步,导致了指导药物开发的越来越复杂的靶标识别。基础神经科学和疾病机制的进步在神经系统疾病方面尤为明显,人们对大脑功能和大脑疾病的潜在机制的理解不断提高。神经治疗学的进步与基础科学方法学、神经影像学、临床试验设计和试验分析的进步是同步发生的。人们越来越热衷于临床试验,因为临床试验可以提供高度可信的数据,从而指导循证医学。美国食品和药物管理局(FDA)要求在临床试验人群测试和药物将被批准的具体适应症之间建立密切联系。这有助于临床试验的扩散,因为试验的行业发起人寻求扩大其产品适用的人群。越来越多的病人和医生参与临床试验。推进临床试验方法学本身已成为一项重大努力。
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