用谷氨酸调节剂增强精神分裂症:一个网络的元分析.
Chun-Wei Liang1, Hsiao-Yi Cheng2, Mei-Chih Meg Tseng3
1Department of Primary Care Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.
Progress in neuro-psychopharmacology & biological psychiatry
|September 13, 2025
概括
谷氨基基调节剂显示出作为精神分裂症的补充治疗的前景. 皮拉,酸和孟坦丁有效地准特定的症状,而组合可以增强认知功能.
科学领域:
- 神经科学和精神病学 在
- 药理学 药理学是指药理学的学科.
背景情况:
- 精神分裂症是一种复杂的精神疾病,尽管采用了标准治疗方法,但症状仍然持久.
- 谷氨酸功能障碍与精神分裂症的病理生理学有关.
- 目前正在研究针对谷氨酸质体系统的新增增强策略.
研究的目的:
- 通过网络元分析,系统地评估谷氨酸调节剂作为精神分裂症补充治疗的疗效.
- 为了比较不同症状领域和认知功能的各种谷氨酸类药物的有效性.
主要方法:
- 在主要的生物医学数据库 (PubMed,Embase,Cochrane图书馆,PsycInfo) 进行了全面的系统搜索,截至2025年1月.
- 使用频率主义方法进行了随机效应网络元分析.
- 使用GRADE (建议,评估,开发和评估的分级) 方法来评估治疗效应的证据确定性.
主要成果:
- 该分析包括了148项随机对照试验,涉及12,339名患者.
- 皮拉 (2400-4800毫克/天) 在总心理病理方面显著改善 (SMD -0.94).
- 酸 (1000-2000毫克/天) 对积极症状 (SMD -0.43) 最有效,而记忆素 (5-20毫克/天) 对负面症状 (SMD -0.64) 最有效.
- 萨科辛 (每天2000毫克) 和酸 (每天1000毫克) 的组合显示出最大的认知增强 (SMD 1.08).
- 孟坦丁,N-乙半氨酸和萨尔科辛在多个症状领域显示出好处.
- 其他几种药物,包括d-serine,evanamide和N-乙半氨酸,以中等到高的确定性证明了有效性.
结论:
- 谷氨酸调节剂代表了精神分裂症增强疗法的有希望的类别,在各种症状维度上提供了好处.
- 像皮拉,酸和孟坦丁这样的特定药物对总体,正面和负面症状分别表现出有针对性的疗效.
- 谷氨酸类药物和单独的药物组合,如美曼丁,N-乙半氨酸和萨尔科辛,有可能改善认知功能,并解决精神分裂症的多个方面.
- 对新型药物和最佳剂量策略的进一步研究是有必要的,以完善谷氨酸增强疗法.
相关概念视频
Psychosis: Pathophysiology of Schizophrenia and Other Psychotic Disorders
1.8K
Schizophrenia is a neurodevelopmental disorder whose origins are rooted in complex genetic components. Despite our burgeoning understanding, the pathophysiology of this disorder remains incompletely deciphered.
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...
1.8K
Antiepileptic Drugs: Glutamate Antagonists
902
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
902
Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists
560
Cognitive enhancers, also known as "smart drugs," are substances used to enhance memory, mental alertness, and concentration. These can be natural or synthetic and improve cognition in conditions like Alzheimer's disease (AD) and other neurodegenerative diseases. Some common examples include caffeine, amphetamines, methylphenidate, modafinil, arecoline, donepezil, vortioxetine, and piracetam. These enhancers work on the principle of synaptic plasticity and altered circuit function.
560
Biological Causes of Schizophrenia
507
Schizophrenia, a severe psychiatric disorder, arises from a complex interplay of biological factors, including genetic predisposition, structural brain abnormalities, neurotransmitter dysregulation, and developmental irregularities. These factors collectively contribute to the onset and progression of the disorder, which typically manifests in late adolescence or early adulthood.
Genetic Factors in Schizophrenia
The genetic basis of schizophrenia is strongly supported by family and twin...
Genetic Factors in Schizophrenia
The genetic basis of schizophrenia is strongly supported by family and twin...
507
Antidepressant Drugs: MAOIs and Other Agents
828
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
828
Drug Therapy
245
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
245


