中枢神经系统抗精神失常药宗濂.pptxVIP

西安交通大学基础医学院药理学系 周筠;精神失常(psychiatric disorders) 是由多种原因引起的精神活动障碍的一类疾病。;感觉：脑对直接作用于感觉器官的客观事物个别属性的反映，是 脑反映现实的最简单的心理过程。 知觉：脑对直接作用于感觉器官的客观事物多种属性和各部分之 间相互关系的综合反映，是比较复杂的心理过程。 记忆：过去的经验在人脑中的反映, 是个复杂的心理过程。 思维：脑对客观现实的概括和间接的反映，反映的是事物的本质 和事物间规律性的联系,构成了人类认识的高级阶段。 情绪：人的自然需要是否得到满足而产生的一种体验。 注意：心理活动对一定事物的指向和集中。 意志：人自觉地确定目的并支配其行为以实现预定目的的心理过程 智能：学习、推理和理解的能力。 人格：人的行为、心理的特征总和。 意识：人脑对客观世界的反映。;精神失常;抗精神病药 (psychotropic drugs) 神经安定药（neuroleptics）;精神分裂症 (schizophrenia) 是以思维、情感、行为之间不协调，精神活动与现实脱离为特征的常见精神病。; 脑内5-HT能系统功能的缺损 GABA神经元的退变 NA功能的不足 脑内DA系统功能亢进 兴奋性氨基酸系统功能低下;脑内DA系统功能亢进学说;多巴胺能神经通路及主要功能;As shown in the panying figure, numerous dopamine pathways are found in the brain. (1) Mesolimbic pathway. Dopamine travels from the midbrain tegmental area to the nucleus accumbens. Increased activity in this pathway may cause delusions, hallucinations, and other so-called positive symptoms of schizophrenia. (2) Mesocortical pathways. There are several mesocortical pathways. Decreased activity in the pathway that goes from the midbrain to the prefrontal lobe cortex can cause apathy, withdrawal, lack of motivation and pleasure, and other so-called negative symptoms of schizophrenia. Mesocortical dysfunction also disinhibits the mesolimbic pathway. (3) Nigrostriatal pathway. The pathway from the substantia nigra to the striatum is involved in the coordination of body movements. Inhibition of this pathway causes the extrapyramidal side effects of antipsychotic drugs. (4) Tuberoinfundibular pathway. The pathway from the hypothalamus to the pituitary inhibits the release of prolactin. Inhibition of this pathway leads to elevated serum prolactin levels.;Some antipsychotic drugs (e.g., clozapine (氯氮平), olanzapine, and risperidone (利培酮) block serotonin 5-HT2 receptors in the mesocortical pathway to the prefrontal lobe cortex. This increases the release of dopamine (DA) and thereby alleviates the negative symptoms of schizophrenia. Most antipsychotic drugs block dopamine D2 recep