打字猴:1.70068758e+09
1700687580 38  Pletscher, A.‘The discovery of antidepressants:a winding path’.Experientia ,47,4-8(1991).
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1700687582 39  Healy, D.Tee Antidepressant Era .(Harvard University Press,1997).
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1700687584 40  不用说,从那时起人们已经开发出了药理学上更复杂同时具有选择性的药物。例如,单胺氧化酶抑制剂(MAOIs)的原型被证明有不良的副作用,例如“奶酪反应”,即任何服用药物的患者都不能食用诸如奶酪、酵母、巧克力或红葡萄酒等富含酪胺的食物:在药物的保护下,无法分解的酪胺(去甲肾上腺素的类似物)便会不断积累,达到某种水平后,便会导致血压的升高和心率的加快,并会增加发生高血压危象的危险性。因此,人们开发出一类新型三环类药物(之所以被称为三环类药物是因为其具有三个环状的化学结构),该类药物仅仅通过更具有选择性地靶向胺类递质就解决了这一问题。这些新型药物通过阻止神经元对去甲肾上腺素和多巴胺的再摄取而发挥作用,这使它们可以在不同的靶点上有较长的作用:食品中的酪胺现在不会再有影响,而服用三环类药物的患者可以再次品尝奶酪和葡萄酒了。最近,抗抑郁药物变得更加精炼,第三代抗抑郁药如百忧解变得更具有选择性,其主要作用于5-羟色胺。
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1700687586 41  Fitzgerald, P. J.‘Forbearance for fluoxetine:do monoaminergic antidepressants require a number of years to reach maximum therapeutic effect in humans?’International Journal of Neuroscience ,124,467-73(2014).
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1700687588 42  Scott, J.‘Cognitive therapy’.British Journal of Psychiatry ,165,126-30(1994);另请参阅Cuijpers, P.et al.‘A meta-analysis of cognitive behavioural therapy for adult depression, alone and in comparison with other treatments’.Canadian Journal of Psychiatry ,58,376-85(2013).
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1700687590 43  Anacker, C.‘Adult hippocampal neurogenesis in depression:behavioral implications and regulation by the stress system’.Current Topics in Behavioral Neuro-sciences (2014).
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1700687592 44  Sheline, Y. I.et al.‘Resting-state functional MRI in depression unmasks in-creased connectivity between networks via the dorsal nexus’.Proceedings of the National Academy of Sciences of the United States of America ,107,11020-5(2010).
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1700687594 45  Ren, J. et al.‘Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression:a systematic review and meta-analysis’.Prog-ress in Neuropsychopharmacology&Biological Psychiatry ,51,181-9(2014).
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1700687596 46  锂的治疗作用由澳大利亚医生约翰·凯德(John Cade)于1948年首次报道。再一次,意外的发现起到了关键性的作用:凯德将精神病患者的尿液注射到豚鼠的腹腔中,试图通过这种方法探索精神疾病可能的生物化学基础。这些豚鼠比注射了健康人尿液的豚鼠死的更快:因此凯德将这一现象归结为精神病患者的尿液中含有更多的尿酸。就在那时,命运发挥了作用:正当凯德试图通过在溶液中加入尿酸锂来提高尿酸的水溶性时,他意外地发现在注射了含有尿酸锂溶液的豚鼠身上,精神病人尿液的毒性大大降低。然而,更有趣的发现是,锂本身对动物具有镇静作用。这是为什么呢?锂强大的治疗作用,尤其是对于躁郁症(与稳态单向抑郁相反)的疗效,已经被证明是个谜。不用说,有各种各样的理论试图对此加以解释,其中就包括了谷氨酰胺的作用,其本身是一种“兴奋性”神经递质和/或一种对血清素有增强作用的调节物质。另一个对象是气体一氧化氮,它在所有的神经递质中体积最小,它的作用涉及神经可塑性。其他的想法还包括,锂可以通过某种方式重置生物钟,以此来调节代谢、体温和睡眠(在双向障碍中发生紊乱),或是抑制肌醇单磷酸酶,否则这种酶会分解肌醇发生畸变,导致出现记忆问题和抑郁。然而,所有这些可能的复杂机制存在的一个共同问题是:在通常情况下,正常人体内所含有的锂并没有影响精神状态的作用,此外,我们在这里讨论的仅仅是一种简单的无机盐。如此基本的物质为何会对那么复杂的精神疾病产生这样选择性的复杂影响呢?Yoshimura, R.et al.‘Comparison of lithium, aripiprazole and olanzapine as augmentation to paroxetine for inpatients with major depressive disorder’.Therapeutic Advances in Psychopharmacology ,4,123-9(2014).De Sousa, R.T.et al.‘Lithium increases nitric oxide levels in subjects with bipolar disorder during depressive episodes’.Journal of Psychiatric Research ,55,96-100(2014).Welsh, D.K.&Moore-Ede, M.C.‘Lithium lengthens circadian period in a diurnal primate, Saimiri sciureus’.Biological Psychiatry ,28,117-26(1990).Brown, K.M.&Tracy, D.K.‘Lithium:the pharmacodynamic actions of the amazing ion’.Teerapeutic Advances in Psychopharmacology ,3,163-76(2013).Buigues, C.et al.‘The relationship between depression and frailty syndrome:a systematic review’.Aging&Mental Health ,1-11(16 Oct.2014).
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1700687598 47  Yanagita, T. et al.‘Lithium inhibits function of voltage-dependent sodium channels and catecholamine secretion independent of glycogen synthase kinase-3 in adrenal chromaffin cells’.Neuropharmacology ,53,881-9(2007).
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1700687600 48  Mason, L. et al.‘Decision-making and trait impulsivity in bipolar disorder are associated with reduced prefrontal regulation of striatal reward valuation’.Brain ,137,2346-55(2014).
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1700687602 49  Hercher, C.,Chopra, V.&Beasley, C. L.‘Evidence for morphological alterations in prefrontal white matter glia in schizophrenia and bipolar disorder’.Journal of Psychiatry and Neuroscience ,39,130277(2014).
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1700687604 50  Muzina, D. J.&Calabrese, J.R.‘Maintenance therapies in bipolar disorder:focus on randomized controlled trials’.Australian and New Zealand Journal of Psychiatry ,39,652-61(2005).
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1700687606 51  Lautenbacher, S.&Krieg, J. C.‘Pain perception in psychiatric disorders:a review of the literature’.Journal of Psychiatric Research ,28,109-22(1994);另请参阅Guieu, R.,Samuélian, J.C.&Coulouvrat, H.‘Objective evaluation of pain perception in patients with schizophrenia’.British Journal of Psychiatry ,164,253-5(1994);以及Dworkin, R.H.‘Pain insensitivity in schizophrenia:a neglected phenomenon and some implications’.Schizophrenia Bulletin ,20,235-48(1994).
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1700687608 52  Giles, L. L.,Singh, M.K.&Nasrallah, H.A.‘Too much or too little pain:the dichotomy of pain sensitivity in psychotic versus other psychiatric disorders’.Current Psychosis and Teerapeutics Reports ,4,134-8(2006).
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1700687610 53  Adler, G.&Gattaz, W. F.‘Pain perception threshold in major depression’.Biological Psychiatry ,34,687-9(1993);另请参阅 Diener, H.C.,van Schayck, R.&Kastrup, O.‘Pain and depression’inPain and the Brain from Nociception to Cognition (eds.Bromm, B.&Desmedt, J.E.)345-55(Raven Press,1995).
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1700687612 54  不过话又说回来,Jasper和Penfield发现,从切除各种癫痫患者相当大一部分大脑皮层(包括不同的区域)并不能使他们不再感受到疼痛。Penfield, W.&Jasper, H.‘Epilepsy and the functional anatomy of the human brain’.(Little, Brown&Co.,1954).
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1700687614 55  Hall, K. R.&Stride, E.‘The varying response to pain in psychiatric disorders:a study in abnormal psychology’.British Journal of Medical Psychology ,27,48-60(1954);另请参阅 Pöllmann, L.&Harris, P.H.‘Rhythmic changes in pain sen-sitivity in teeth’.International Journal of Chronobiology ,5,459-64(1978).
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1700687616 56  Koyama, T. et al.‘The subjective experience of pain:where expectations become reality.Proceedings of the National Academy of Sciences of the United States of America ,102,12950-5(2005).
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1700687618 57  Ramachandran, V. S.&Blakeslee, S.Phantoms in the Brain:Probing the Mysteries of the Human Mind .(Harper Perennial,1998).
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1700687620 58  Melzack, R.&Wall, P. D.Tee Challenge of Pain .(Penguin,1996).
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1700687622 59  Kupers, R. C.,Konings, H.,Adriaensen, H.&Gybels, J.M.‘Morphine differentially affects the sensory and affective pain ratings in neurogenic and idiopathic forms of pain’.Pain ,47,5-12(1991).
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1700687624 60  Ponterio, G. et al.‘Powerful inhibitory action of mu opioid receptors(MOR)on cholinergic interneuron excitability in the dorsal striatum’.Neuropharmacology ,75,78-85(2013).
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1700687626 61  Lautenbacher&Krieg,1994;另请参阅 Guieu, Samuélian&Coulouvrat,1994;and Dworkin,1994.
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1700687628 62  Rang, H. P.et al.Rang and Dale’s Pharmacology .(Churchill Livingstone,2012).
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