Pharmacological and Nonpharmacological Interventions to Arrest Neuroprogression in Psychiatric Disorders.

Modern trends in pharmacopsychiatry Pub Date : 2017-01-01 Epub Date: 2017-07-24 DOI:10.1159/000470814
Fotini Boufidou, Angelos Halaris
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引用次数: 9

Abstract

The concept of neuroprogression describes the progressive course of the disorder and stresses the progressive, recurrent, and chronic course of the disease entity under consideration. It subsumes clinical manifestations of the disease process and may also entail morphological, biochemical, neurochemical, immunological, physiological, and genetic aspects that contribute to the progressive course of the disease in question. In an attempt to identify the appropriate agent or method that could arrest neuroprogression in psychiatric patients, we conducted an evaluation of the use of anti-inflammatory drugs under the perspective of current pharmacological and neurophysiological data. This evaluation included the use of nonsteroidal anti-inflammatory drugs (NSAIDs) as adjunctive treatment to conventional pharmacotherapy as well as the use of natural products exerting anti-inflammatory properties (i.e., ω-3 fatty acids) given as adjunctive or monotherapeutic treatments in less severe cases. The therapeutic significance of nonpharmacological methods, such as psychotherapy, physical exercise, and body-mind therapies, was also considered and will be discussed in this chapter. In conclusion, the role of psychotropic and select anti-inflammatory drugs in arresting neuroprogression is a very promising new frontier in psychiatric research and clinical practice. Modulators of a specific prostanoid synthase or receptor across the cyclooxygenase (COX)-2 downstream pathway along with new multitarget NSAIDs are expected to be tested by the pharmaceutical industry as potential agents to antagonize neuroprogression. Meanwhile, salicylates and selective COX-2 inhibitors could still be used in carefully selected subgroups of patients. Psychotherapy and nonpharmacological, stress-relieving methods should be considered as adjunctive tools to aid in arresting neuroprogression.

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阻止精神疾病神经进展的药物和非药物干预。
神经进展的概念描述了疾病的进展过程,并强调了所考虑的疾病实体的进展性、复发性和慢性过程。它包括疾病过程的临床表现,也可能涉及形态学、生化、神经化学、免疫学、生理学和遗传方面,这些方面有助于疾病的进展过程。为了寻找合适的药物或方法来阻止精神病患者的神经进展,我们从目前的药理学和神经生理学数据的角度对消炎药的使用进行了评估。该评估包括使用非甾体抗炎药(NSAIDs)作为常规药物治疗的辅助治疗,以及在较轻的病例中使用具有抗炎特性的天然产物(即ω-3脂肪酸)作为辅助治疗或单药治疗。非药物方法的治疗意义,如心理治疗、体育锻炼和身心疗法,也被考虑并将在本章中讨论。综上所述,精神药物和选择性抗炎药物在抑制神经进展中的作用是精神病学研究和临床实践中一个非常有前途的新领域。通过环氧化酶(COX)-2下游通路的特定前列腺素合成酶或受体调节剂以及新的多靶点非甾体抗炎药有望被制药行业作为对抗神经进展的潜在药物进行测试。同时,水杨酸盐和选择性COX-2抑制剂仍可用于精心挑选的患者亚组。心理治疗和非药物缓解压力的方法应被视为辅助工具,以帮助阻止神经进展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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Inflammation Effects on Glutamate as a Pathway to Neuroprogression in Mood Disorders. The Link between Refractoriness and Neuroprogression in Treatment-Resistant Bipolar Disorder. The Contribution of Adult Hippocampal Neurogenesis to the Progression of Psychiatric Disorders. Neurodegeneration, Neuroregeneration, and Neuroprotection in Psychiatric Disorders. Pharmacological and Nonpharmacological Interventions to Arrest Neuroprogression in Psychiatric Disorders.
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