新型多模式作用抗抑郁药伏硫西汀的研究进展

Recent research advances about vortioxetine:a novel multimodal antidepressant

伏硫西汀(vortioxetine)于2013年通过美国FDA批准上市,并于2017年11月通过国家药品监督管理局批准在中国上市,用于治疗成人抑郁症。该药通过抑制5-HT转运体介导的5-HT再摄取,同时调节多种5-HT受体活性而发挥抗抑郁作用。体外和动物研究表明,伏硫西汀除增加脑内5-HT浓度外,还可增强大脑某些区域的多巴胺、去甲肾上腺素、乙酰胆碱、组胺和谷氨酸神经传递,并降低γ-氨基丁酸神经传递。临床研究显示,伏硫西汀可同时改善抑郁症患者症状及认知功能,促进其社会功能恢复。本文就其作用机制、临床有效性和安全性、真实世界研究、临床应用等进行阐述。

Vortioxetine was approved by the US FDA in 2013 and by China Food and Drug Administration in November 2017 for the treatment of major depressive disorder(MDD)in adults.Vortioxetine exerts antidepressant effects by inhibiting 5-HT transporter-mediated 5-HT reuptake and regulating the activity of multiple 5-HT receptors.Vitro and animal studies have shown that,in addition to increasing 5-HT concentrations,vortioxetine elevates dopamine,norepinephrine,acetylcholine,histamine,and glutamate neurotransmission and decreases GABA neurotransmission in some brain areas associated with MDD.Clinical studies indicate that vortioxetine can relieve multidimensional symptoms,improve cognitive functions,and promote the recovery of social function in MDD patients.This article comprehensively reviews vortioxetine for the treatment of depression in aspects of the mechanism of action,clinical efficacy and safety,real-world studies,and clinical application.