American Psychiatric Association (APA) 2015 annual meetingSaint Louis Medical College, Henry A. director of the psychiatric Dr. Nasrallah in
American Psychiatric Association (APA) 2015 annual meeting
Saint Louis Medical College, Henry A. director of the psychiatric Dr. Nasrallah in the American Psychiatric Association (APA) 2015 annual meeting was entitled "beyond" science: the development of dopamine in the treatment of schizophrenia report. The report pointed out that 95% of patients with first-episode psychosis before the onset of primary health care institutions to consult, showing the importance of the identification of precursor symptoms and risk factors.
Dr. Nasrallah pointed out that as a neurodevelopmental disorder characterized by progressive brain atrophy, we need to find schizophrenia in a timely manner. With the increase in the number of attacks, the ventricular system of patients with schizophrenia will expand. Nasrallah said, "can't we do something?"
First of all, gray matter loss, "the loss of parietal lobe, temporal lobe and prefrontal cortex," and the loss of dendritic spines, which are the basis of cognition and memory, Nasrallah noted. "Although we found evidence of neurodegeneration in schizophrenia," we have been focused on dopamine".
In addition to the overall loss of gray matter and dendritic spines, the glial cells of the patients with schizophrenia will die, or thus lead to their gray matter defects, rather than due to neuronal loss. Dr Nasrallah found that: "psychotic episodes during glial cell death, neurons become isolated and helpless". It is still a hot topic in the research on the influence of schizophrenia on glial, but there are still some controversies about the nature of the effect.
To make matters worse, neurons have the ability to support and differentiate, and the nutritional factors that depend on them, such as brain-derived neurotrophic factor (BDNF).
The researchers conducted a large number of studies of neurogenesis (neurogenesis) and antipsychotic drugs, and found that the second generation of atypical antipsychotic drugs can increase neurogenesis. And atypical antipsychotics may improve the levels of neurotrophic factors in the brains of patients with schizophrenia.
In view of a large number of research evidence, neurochemical models of schizophrenia than dopamine? Dr. Nasrallah questioned the practice of focusing only on the nervous system. "Why don't we use the GABA agonist combined with dopamine antagonists?" Sodium nitroprusside (nitroprusside) or antihypertensive drugs can be effective in the treatment of schizophrenia. Oxytocin (Oxytocin) is also possible.
Dr. Nasrallah believes that the treatment should focus on the developmental dimension of schizophrenia. Prevention or help, for example, to avoid exposure to pregnant women can increase the risk of schizophrenia related factors, such as: maternal infection, toxoplasmosis and gestational diabetes.
Dr. Nasrallah also suggests that we can prevent neurodegeneration by minimizing the risk of mental illness by early intervention with long-acting atypical antipsychotics. In short, Dr. Nasrallah believes that we urgently need to "break through the current focus of our treatment methods and strategies."
Medical Naomaitong compiler, please indicate the source.
Interpreter: Schizophrenia: It from vein medicine 's Not Just About Dopamine By Alisa G. Woods, PhD APA 2015 Psychiatric Times