匹莫范色林治疗精神症状相关临床研究进展

Pimavanserin for Treatment of the Psychiatric Symptoms:the Clinical Research Progress

帕金森病(PD)是一种老年人常见的中枢神经退行性疾病,除了典型运动症状以外,非运动症状如精神病性症状日益被人们所重视,有近一半的PD患者存在精神症状,且随患病时间增长而进展,给患者及其照料者带来极大困扰。另外,PD以及其他中枢神经变性疾病会导致认知障碍,对患者晚年生活质量产生巨大影响,精神症状在认知障碍患者中十分常见,同时也是痴呆进展的危险因素之一。既往使用的抗精神病药物在临床应用中存在明显的不良反应,因此急需有效且不良反应少的抗精神病药物来治疗PD及痴呆相关精神症状。匹莫范色林是一种选择性5-羟色胺2A(5-HT2A)受体反向激动药,对它的Ⅰ期、Ⅱ期及Ⅲ期临床研究及开放性临床研究均得出了较好的数据结果,提示这是一种有效且安全的治疗PD精神症状的新药物。同时有限的临床研究发现匹莫范色林也是一种有潜力的阿尔茨海默病性精神病治疗药物,对其他痴呆相关精神病的疗效仍在研究中。

Parkinson’s disease(PD)is a common central neurodegenerative disease in the elderly.In addition to typical motor symptoms,non-motor symptoms such as psychotic symptoms are increasingly valued.Nearly half of PD patients have psychiatric symptoms and progress with the increase of time,bringing patients and their caregivers great trouble.Besides,PD and other central neurodegenerative diseases can cause cognitive impairment,which has a great impact on the quality of life of patients in later life.Psychiatric symptoms are very common in patients with cognitive impairment,and are also one of the risk factors for progression of dementia.At present,antipsychotic drugs commonly used in clinic have obvious side effects on the treatment of this kind of psychotic symptoms,which means antipsychotic drug with effectiveness and low side effects is urgently needed to treat PD and dementia-related psychiatric symptoms.Pimavanserin is a selective inverse agonist at serotonin 5-HT2 A receptors and an antagonist at 5-HT2 c receptors.The PhaseⅠ,PhaseⅡand PhaseⅢclinical studies and other open clinical studies of pimavanserin have obtained desirable results,suggest that this is an effective and safe new drug for the treatment of PD psychiatric symptoms.At the same time,limited clinical studies have found that pimavanserin is also a potential treatment for psychiatric symptoms related to Alzheimer’s disease,it’s efficacy of other dementia-related psychosis is still under study.