锂盐在精神疾病中的应用

The application of lithium in mental disorder

锂盐作为情绪稳定剂用于治疗双相情感障碍已有60多年的历史,大量研究证明锂盐用于治疗急性躁狂以及对预防双相情感障碍的反复发作有效。锂盐还具有独特的预防自杀风险的效应,可降低情感障碍患者的自杀风险。最近锂盐在神经精神方面的应用研究有了新的进展,其独特的机制更是在不同的领域中被发现并应用,锂盐通过作用于GSK-3的抑制来发挥神经保护作用,这种保护作用对神经退行性疾病阿尔茨海默病、帕金森病、亨廷顿病的防治具有潜在用途。几个旨在评估锂盐对这些疾病疗效的临床试验正在进行中。

Lithium as a mood stabilizer has been used in the standard pharmacological treatment of bipolar disorder （BD） for more than 60 years. It remains to be recommended by many treatment guidelines as the ifrst-line treatment for acute mania, and prophylactically for recurrent manic and depressive episodes. Lithium can help prevent suicide and is associated with a lower risk for all-cause mortality in patients with mood disorders. Evidence from preclinical studies suggests that neuroprotection induced by lithium is mainly related to its potent inhibition of the enzyme glycogen synthase kinase-3 （GSK-3） and its downstream effects, which may have a potential use in the treatment of a wide variety of neurodegenerative disorders such as Alzheimer’s, Parkinson’s and Huntington’s diseases. Several clinical trials are also underway to assess the therapeutic effects of lithium on these disorders.