治疗神经性厌食症的药物治疗策略--打破恶性循环的新目标。

IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY Expert Opinion on Pharmacotherapy Pub Date : 2024-11-05 DOI:10.1080/14656566.2024.2424316
Millie C Kirchberg, Claire Pinson, Guido K W Frank
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引用次数: 0

摘要

简介神经性厌食症(AN)是死亡率最高的精神疾病之一。目前尚无针对神经性厌食症的经批准的药物治疗方法,但新的神经生物学靶点显示出治疗前景:研究表明,神经性厌食症患者的大脑神经递质信号发生改变,同时伴有精神僵化、合并焦虑和抑郁。现有疗法和新疗法可用于改善神经生物学和行为学的改变。这篇叙述性综述回顾了之前发表的文献,评估了传统药物疗法治疗自闭症的疗效,同时还探讨了新型疗法,包括解离性麻醉剂、迷幻剂、大麻素、激素、神经类固醇和生酮营养:如果最佳心理治疗干预无效,我们建议采用以神经科学和脑科学研究为基础的药物治疗方法,以多巴胺神经递质受体为靶点,增强认知灵活性和疾病洞察力,同时减少对食物的恐惧和回避。此外,认识并治疗焦虑症、抑郁症或强迫症等合并症也很重要,因为这些疾病会影响患者的康复,而且即使成功治疗了自闭症,这些疾病通常也不会消失。新策略有望在改善情绪和减少特定 AN 精神病理学方面显示出疗效,并有望很快应用于临床实践。
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Pharmacotherapeutic strategies for the treatment of anorexia nervosa - novel targets to break a vicious cycle.

Introduction: Anorexia nervosa (AN) has one of the highest mortality rates of all mental illnesses. No approved pharmacological treatments exist for AN, but novel neurobiological targets show promise.

Areas covered: Studies show that in individuals with AN, there are alterations in brain neurotransmitter signaling, alongside associated mental rigidity and comorbid anxiety and depression. Available and new therapies could be used to improve alterations in neurobiology and behavior. This narrative review serves as a review of previously published literature assessing the efficacy of traditional pharmacotherapy in treating AN while also exploring novel treatments, including dissociative anesthetics, psychedelics, cannabinoids, hormones, neurosteroids, and ketogenic nutrition.

Expert opinion: If best practice psychotherapeutic interventions have failed, we recommend a neuroscience and brain research-based medication approach that targets dopamine neurotransmitter receptors to enhance cognitive flexibility and illness insight while reducing dread and avoidance toward food. It is furthermore essential to recognize and treat comorbid conditions such as anxiety, depression, or obsessive-compulsive disorder as they interfere with recovery, and typically do not resolve even with successful AN treatment. Novel strategies have the promise to show efficacy in improving mood and reducing specific AN psychopathology with hopes to be used in clinical practice soon.

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来源期刊
CiteScore
5.60
自引率
3.10%
发文量
163
审稿时长
4-8 weeks
期刊介绍: Expert Opinion on Pharmacotherapy is a MEDLINE-indexed, peer-reviewed, international journal publishing review articles and original papers on newly approved/near to launch compounds mainly of chemical/synthetic origin, providing expert opinion on the likely impact of these new agents on existing pharmacotherapy of specific diseases.
期刊最新文献
Pharmacological management of heart failure: a patient-centred approach. Evaluating Vonoprazan for the treatment of erosive GERD and heartburn associated with GERD in adults. Metabolic-associated steatotic liver disease and hepatocellular carcinoma. Reassessing the role of aspirin in patients with coronary artery disease. Pharmacotherapeutic strategies for the treatment of anorexia nervosa - novel targets to break a vicious cycle.
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