Neuroadaptations to antipsychotic drugs: Insights from pre-clinical and human post-mortem studies

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:76

Review

Amato, Davide¹  Beasley, Clare L.²  Hahn, Margaret K.³  Vernon, Anthony C.⁴ 

[1] Friedrich Alexander Univ Erlangen Nurnberg, Dept Psychiat & Psychotherapy, Erlangen, Germany

[2] Univ British Columbia, Dept Psychiat, Vancouver, BC, Canada

[3] Univ Toronto, Complex Mental Illness, Ctr Addict & Mental Hlth, Dept Psychiat,Inst Med Sci, Toronto, ON, Canada

[4] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Basic & Clin Neurosci, Maurice Wohl Clin Neurosci Inst, 5 Cutcombe Rd, London SE5 9RT, England

关键词: Antipsychotic;    Schizophrenia;    Microdialysis;    Receptor binding affinity;    Monoamine;    Neuroadaptation;    Insulin;    Treatment efficacy/failure;    Post-mortem;    Neuropathology;    Magnetic resonance imaging;   

DOI  :  10.1016/j.neubiorev.2016.10.004

来源: Elsevier

【 摘 要 】

Antipsychotic drugs, all of which block the dopamine D2 receptor to a greater or lesser extent, are the mainstay for the pharmacological treatment of schizophrenia. Engaging in a deeper understanding of how antipsychotics act on the brain and body, at the cellular, molecular and physiological level is vital to comprehend both the beneficial and potentially harmful actions of these medications and stimulate development of novel therapeutics. To address this, we review recent advances in our understanding of neuroadaptations to antipsychotics, focusing on (1) treatment efficacy, (2) impact on brain volume and (3) evidence from human post-mortem studies that attempt to dissect neuropathological effects of antipsychotic drugs from organic schizophrenia neurobiology and (4) cardio-metabolic side effects. Our aim is to stimulate discussion on these highly clinically relevant topics and consider how we might use current and evolving knowledge and new methodologies in the fields of neuropharmacology and neuroscience, to advance our understanding of the long-term impact of antipsychotic treatment. Ultimately, this may inform the clinical use of these drugs. (C) 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

【 授权许可】

Free