抗抑郁药物的研究进展

Progress on antidepressants

目的:对临床上使用的及临床试验中的抗抑郁药物进行分析和总结,拟为今后新型抗抑郁药物的研发提供参考。方法:通过查阅近年的文献,将抗抑郁药物按照机制进行归纳和整理。结果:从第一代的三环类、单胺氧化酶抑制剂类抗抑郁药物,到第二代的基于单胺类神经递质及相应受体所研发的药物,之前的研发集中在调节单胺类神经递质的摄取和释放方面。而随着氯胺酮等快速起效的抗抑郁药物的发现,新的靶点,比如谷氨酸神经递质及相关通路成为研究的热点。结论:抗抑郁药物的发展仍会遵循着单胺类的策略,但是靶向谷氨酸神经递质系统的药物及联合用药是新的发展趋势。

Objective： To analyze and summarize antidepressants （ADT） available in clinical treatment and trials. Methods： Recent literatures on ADT are reviewed, and drugs are classified and summarized according to mechanism. Results： From the first-generation ADT including tricyclic antidepressant （TCA） and monoamine oxidase inhibitor （MAOI） to the second-generation ADT focusing on function of monoamine transmitters and receptors, the past decades have witnessed the era of monoamine, with concentration on regulation of uptake and efflux of monoamine transmitters. However, with the development of rapid-acting drugs, like ketamine, researchers have paid attention to other mechanisms of drugs, like regulation of glutamate and GABA transmission. Conclusion： The development of majority of ADTs will still focus on monoamine, while targeting glutamate and GABA transmitter and combined therapy are the growing trend.