皮质类固醇诱导的神经精神疾病影响的分子,病理生理和临床方面:从长椅到床边
Sara Sofía-Avendaño-Lopez1,2, Angela Johanna Rodríguez-Marín2, Mateo Lara-Castillo2
1Social Epidemiology Research Team, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Université, F 75012 Paris, France.
Biomedicines
|September 28, 2024
概括
皮质类固醇可以引起神经精神症状,如焦虑和精神病,由于复杂的细胞变化. 在大多数情况下,停止使用皮质类固醇可以缓解症状,但当戒断不可能时,精神药物可以帮助.
科学领域:
- 神经科学是一个神经科学.
- 药理学 药理学 是一个学科.
- 内分泌学 在内分泌学.
背景情况:
- 皮质类固醇被广泛使用,但与神经精神病学不良影响有关.
- 这些效应已知60多年,涉及复杂的细胞机制.
- 症状包括情感,精神和认知障碍,往往被诊断不足.
研究的目的:
- 审查皮质类固醇诱导的神经精神症状的细胞机制.
- 讨论临床表现和诊断挑战.
- 概述治疗策略,包括停药和药理干预措施.
主要方法:
- 对皮质类固醇诱导的神经精神症状的研究的文献综述.
- 对涉及这些不良影响的细胞通路的分析.
- 综合临床病例报告和关于心理药物疗效的有限研究.
主要成果:
- 细胞机制涉及神经元刺激能力的改变,细胞死亡,炎症和氧化应激.
- 临床症状范围从情绪变化和精神病到认知缺陷.
- 停用皮质类固醇可使多达80%的患者的症状消失.
结论:
- 神经精神症状是皮质类固醇治疗的显著不良影响.
- 早期识别和停止治疗是关键的治疗方法.
- 心理药物可能是有益的,当皮质类固醇戒断是不可行的.
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