小鼠灌胃大枣提取物后血清和海马组织中环磷酸腺苷的含量变化

目的 :观察小鼠ig给予大枣提取物(0.35 g ·kg^-1)后24 h内血清和海马组织中环磷酸腺苷(cAMP)含量随时间的变化规律,初步阐明大枣提取物抗抑郁作用可能的机制。 方法 :首先采用高效液相色谱法测定大枣提取物种cAMP的含量,再使用健康ICR小鼠,单次ig给予大枣提取物后在0.5,1,2,4,6、8,12,24 h股动脉取血,分离海马组织,采用荧光ELISA法测定血清和海马组织中cAMP浓度。 结果 :大枣提取物中cAMP的平均含量为1.54%。血清中cAMP浓度在0.5 h达最大值,在8 h内逐渐减少,在8~12 h又明显升高,此后又开始降低。而海马组织中cAMP浓度在前6 h之内缓慢升高,6~8 h内明显升高,24 h达最大值。 结论 :大枣提取物中可能同时存在具有磷酸二酯酶抑制作用的物质,能够在6~12 h内抑制磷酸二酯酶的活性,增加cAMP的浓度,这可能是大枣提取物抗抑郁的作用机理之一。     

积雪草总三萜酸及其主要成分的抗抑郁活性研究

目的:探讨积雪草总三萜酸和其主要成分积雪草酸、羟基积雪草酸的抗抑郁作用.方法:采用小鼠强迫游泳实验、小鼠悬尾实验、开野实验和拮抗利血平所致的小鼠眼睑下垂实验,分别以小鼠不动时间、自主活动数和拮抗率作为评价指标.结果:在强迫游泳实验中积雪草总三萜酸、积雪草酸、羟基积雪草酸60 mg/kg、120 mg/kg剂量均能显著缩短小鼠不动时间,在悬尾实验中30 mg/kg、60 mg/kg、120 mg/kg剂量均能显著缩短小鼠不动时间,开野实验结果表明给药后小鼠的自主活动无明显变化,在利血平拮抗实验中积雪草总三萜酸、积雪草酸、羟基积雪草酸均可减少小鼠眼睑下垂.结论:积雪草总三萜酸、积雪草酸、羟基积雪草酸有抗抑郁作用.     

血脑屏障上的P-糖蛋白与精神类药物

P-糖蛋白(P-gp)是ABC超家族的重要成员,而许多精神药物包括抗精神分裂症药物和抗抑郁症药物,都是P-gp的底物。本文对近年来国内外有关P-gp对精神药物限制进入血脑屏障的相关研究,进行了综述。     

联合抗抑郁药治疗功能性消化不良的疗效观察

目的探讨联合抗抑郁药氟哌噻吨美利曲辛片治疗功能性消化不良(FD)的临床疗效。方法将96例FD患者,随机分为两组,对照组48例应用内科常规治疗(抑酸药和/或促胃动力药),治疗组48例在对照组基础上加用抗抑郁药氟哌噻吨美利曲辛片联合治疗,治疗时间均为8周。以自制FD症状评定量表(FDSR)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评定疗效。结果治疗8周,治疗组总有效率分别为83.34%(40)高于及对照组64.58%(31),两组比较差异有统计学意义(P<0.05)。结论联合抗抑郁药氟哌噻吨美利曲辛片治疗功能性消化不良疗效显著,是一个理想的FD治疗方案。     

Criticisms of drugs in early development for the treatment of depression: what can be improved?

Major depressive disorder (MDD) is a common and debilitating mental illness, which leads to serious functional impairment in patients, and treatment-wise, there are currently a number of different classes of antidepressants already on the market. However, emerging evidence from numerous clinical trials has confirmed that there is still an unmet need for antidepressant efficacy in terms of response and remission. Approximately only 30% of patients with MDD may remit after adequate treatment with antidepressants in clinical practice. The drawbacks of the currently available antidepressants also include inadequate overall efficacy, safety issues and the lag prior to onset of clinical improvement. The need for new agents with novel mechanisms of action has led to the development of several newer antidepressants including vilazodone, edivoxetine, ketamine, atomoxetine and vortioxetine, which have been approved for the treatment of MDD. However, the efficacy and safety of these next-generation antidepressants, in clinical trials, are still unsatisfactory. This paper provides a brief updated overview of the progress and critical limitations in the development of novel antidepressants.     

我院1998年～2001年抗抑郁药物的应用分析

目的 :了解我院抗抑郁药的应用状况及发展趋势。方法 :采用金额排序和频度分析方法对我院1998年～2001年抗抑郁药的应用情况进行统计分析。结果 :抗抑郁药的年用药金额及用药频度(DDDs)逐年提高 ,2001年各种抗抑郁药年用药金额及DDDs分别是1998年的3 69倍和2 14倍。三环类抗抑郁药所占金额比例虽然不高 ,但其DDDs连续4年列前5位的药有氯米帕明和多塞平。新型抗抑郁药因其副作用相对少而轻 ,治疗地位不断上升 ,所占金额比例较高。结论 :三环类抗抑郁药仍是治疗抑郁症的首选 ;新型抗抑郁药应用前景广阔 ;尚需加速开发治疗抑郁症的中药     

Antidepressant Effects of Ethanol Extract of Areca catechu in Rodents

We report on the antidepressant activity in the ethanol extract of Areca catechu. Antidepressant activity was evaluated in rodents using the forced swimming and tail suspension tests. The ethanol extract (4–80 mg/kg) caused a significant reduction in the immobility time without effecting the spontaneous motor activity. Our findings suggest that the ethanol extract possesses antidepressant activities. © 1997 by John Wiley & Sons, Ltd.     

Cost-Effectiveness of Repetitive Transcranial Magnetic Stimulation versus Antidepressant Therapy for Treatment-Resistant Depression

BackgroundRepetitive transcranial magnetic stimulation (rTMS) therapy is a clinically safe, noninvasive, nonsystemic treatment for major depressive disorder.ObjectiveWe evaluated the cost-effectiveness of rTMS versus pharmacotherapy for the treatment of patients with major depressive disorder who have failed at least two adequate courses of antidepressant medications.MethodsA 3-year Markov microsimulation model with 2-monthly cycles was used to compare the costs and quality-adjusted life-years (QALYs) of rTMS and a mix of antidepressant medications (including selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, tricyclics, noradrenergic and specific serotonergic antidepressants, and monoamine oxidase inhibitors). The model synthesized data sourced from published literature, national cost reports, and expert opinions. Incremental cost-utility ratios were calculated, and uncertainty of the results was assessed using univariate and multivariate probabilistic sensitivity analyses.ResultsCompared with pharmacotherapy, rTMS is a dominant/cost-effective alternative for patients with treatment-resistant depressive disorder. The model predicted that QALYs gained with rTMS were higher than those gained with antidepressant medications (1.25 vs. 1.18 QALYs) while costs were slightly less (AU $31,003 vs. AU $31,190). In the Australian context, at the willingness-to-pay threshold of AU $50,000 per QALY gain, the probability that rTMS was cost-effective was 73%. Sensitivity analyses confirmed the superiority of rTMS in terms of value for money compared with antidepressant medications.ConclusionsAlthough both pharmacotherapy and rTMS are clinically effective treatments for major depressive disorder, rTMS is shown to outperform antidepressants in terms of cost-effectiveness for patients who have failed at least two adequate courses of antidepressant medications.     

苏郁胶囊对抑郁模型小鼠行为及海马神经元损伤的影响

目的：探究苏郁胶囊对慢性应激抑郁模型小鼠行为、海马神经元损伤及海马突触体内游离Ca²⁺浓度的影响。方法:将60只昆明种雄性小鼠分为正常组、模型组、苏郁胶囊高、中、低剂量组（22.8,11.4,5.7 g·kg^-1）。采用长期不可预见性中等强度应激造成小鼠抑郁模型。测定各组小鼠体重变化,Open-field法和糖水消耗实验测定各组小鼠的行为变化；Nissl染色法观察海马CA1,CA3区神经元形态及锥体细胞数目；以Fura-2负载及荧光分光光度计检测海马突触体内游离Ca²⁺浓度。结果:与正常组比较,模型组小鼠体重增长缓慢(P<0.01),水平活动得分和垂直活动得分显著减少(P<0.01),糖水消耗量明显降低(P<0.01)；海马CA3区锥体细胞数量明显减少(P<0.01)；海马突触体内游离Ca²⁺浓度明显升高(P<0.01)；苏郁胶囊高剂量组于第14,21天时小鼠体重增长数明显高于模型组（P<0.05）；苏郁胶囊高剂量能增加抑郁小鼠的水平活动得分(P<0.05)；苏郁胶囊高、中剂量组能增加抑郁小鼠的垂直活动得分(P<0.01,P<0.05)；苏郁胶囊高、中、低剂量能明显增加抑郁小鼠的糖水消耗量(P<0.01,P<0.05,P<0.05)；苏郁胶囊高、中、低剂量组能明显增加海马CA3区锥体细胞数量 (P<0.01,P<0.05,P<0.05)；苏郁胶囊高、中、低剂量组能明显降低抑郁小鼠海马突触体内游离Ca²⁺浓度(P<0.01,P<0.01,P<0.05)。结论:苏郁胶囊能改善小鼠的抑郁样行为；保护抑郁模型小鼠海马神经元损伤,其可能与苏郁胶囊抑制海马神经细胞外Ca²⁺内流,阻止Ca²⁺超载相关。     

当归抗抑郁化学成分及药理作用研究进展

通过文献分析,总结了当归在治疗抑郁症中的应用现状,发现当归所含的有机酸类、苯酞类、多炔类成分具有良好的抗抑郁、神经保护及单胺类递质再摄取等作用。当归抗抑郁作用的机制与其对神经损伤、神经递质系统紊乱和氧化应激等方面具有改善作用相关,以期为当归临床治疗抑郁症提供科学依据。