抑郁症库宝善教授.pptVIP

忧郁症常见于： 　　 ●妇女患有忧郁症的可能性是男性的两倍。 　　●每年有1千1百多万的女性患上临床忧郁症。 　　●忧郁症是导致女性患病的最主要因素。 　　 ●忧郁症在育龄妇女中最为常见，但是任何年龄的人都可能患上这种病症。 　 　●忧郁症和许多生理疾病相关。  　　●患有其他疾病，比如心脏病、中风、癌症及糖尿病的患者忧郁症的发病率更高。  　　●忧郁症患者在医疗检查、约见医生、医疗门诊电话咨询等所占的比例相当大。  青春期忧郁症 每个人都会有不快乐和心情不好的时候，但是如果持续太久，那就是忧郁了。忧郁是大部分人都有的经验，但是当忧郁一直持续下去，愈来愈严重以致于无法过正常的日子，即称为忧郁症(depression)。 Fig. 2 Stimulation of serotonin synthesis and release by tryptophan administration. Fig. ３ Hypothesized mechanism of serotonin transport across the plasma membrane. Catabolism of serotonin. Serotonin is initially catabolized by the mitochondrial enzyme monoamine oxidase (MAO) to yield the intermediate 5-hydroxyindoleacetaldehyde. This compound is then rapidly converted to 5-hydroxyindoleacetic acid (5-HIAA) by the enzyme aldehyde dehydrogenase. 线粒体的ＭＡＯ（主要是Ａ型）将５－ＨＴ代谢为５－羟吲哚乙酸(5-HIAA) 单胺氧化酶（ＭＡＯ）和ＭＡＯ抑制剂 MAO有A和B两个亚型， DA是A和B两型的混合型底物。 苯环丙胺(tranylcypromine)是混合型的MAO阻断剂，容易引起“酪胺反应”。 小剂量的帕吉林(pargyline)优先抑制B型，大剂量时则抑制A和B两型。 司来吉兰(selegiline, deprenyl)是专一制MAO－B。 氯吉兰(clorgyline)和吗氯贝胺（ moclobemide ）选择性抑制MAO－A Fig. ４ Structure of the rat 5-HT1A receptor. The amino acids shown in color indicate residues in common with the hamster b2-adrenergic receptor. putative phosphorylation sites (negative charges) Fig. 5 Isolation-induced aggression in mutant mice lacking the 5-HT1B receptor. Male mice were isolated for 4 weeks and their aggressive responses to an intruder male. Three strains of animals were tested: wild-type mice, mutant mice homozygous for deletion of the 5-HT1B receptor gene, and heterozygous mice expressing one copy of the gene. Fig.6 Effects of serotonergic agonist or antagonist treatment on aggressive behavior in male monkeys.Subjects were given either serotonergic agonists (tryptophan or fluoxetine) or serotonergic antagonists (cyproheptadine or fenfluramine) for 4 weeks Fig 7．Effects of fenfluramine(氟苯丙氨, 60 mg) and phentermine(芬特明, 15 mg) on body weight of obese human subjects. (n =