论文部分内容阅读
发作性睡病的流行病学不清,但在美国约10万人患病.大约80%患者伴有猝倒.拟交感药物可使发作性睡病缓解,但对猝倒作用甚微或无效.因而,许多病人需二种或更多的药物治疗.Akimoto氏等发现丙咪嗪对猝倒有较好的选择性作用而不影响睡眠发作.近来Brodie氏等报告去甲基丙咪嗪比丙咪嗪的抗抑郁作用强而迅速.Clomipramine由Passouant等推荐是一种作用较其他药物皆强的制剂,可使大多数病人猝倒的频度减少50%或更多;但由于其耐受性及副作用而使疗效受限.Clomipramine及一小部份三环剂对可使突触后受体刺激性加强的中枢5-羟色胺介质传递有较大的影响.类似作用的另一些药物,如5-羟色胺前体、5-羟色胺酸(5-HTP)及单胺氧化酶抑制剂亦有缓解猝倒发作的报告.这些药物和抗猝倒作用可能由于中缝核及终止于前角细胞的下降性血清素源通路的5-羟色胺受体活性变化所致.
The epidemiology of narcolepsy is unclear, but is estimated at about 100,000 in the United States and catastrophe occurs in about 80% of patients. Sympathetic drugs relieve narcolepsy but have little or no effect on cataplexy .Accordingly, many patients need two or more drug treatment.Akimoto’s etc. found that imipramine has a good selective effect on cataplexy without affecting the onset of sleep.Recently Brodie’s and other reports of methylpheniramine ratio The antidepressant effect of imipramine is strong and rapid.Clomipramine, recommended by Passouant et al, is a stronger agent than any other drug and can reduce catalysing frequency by 50% or more in most patients; however, due to its tolerance Sexual and side effects and the curative effect is limited.Clomipramine and a small part of the tricyclic agent can stimulate the postsynaptic receptors in the central serotonin transmission has a greater impact.Similar drugs such as the role of other such as Serotonin precursors, 5-hydroxytryptophan (5-HTP), and monoamine oxidase inhibitors have also been reported to relieve cataplexy and these drugs and antidebrosations may be due to the hypothalamic nucleus and descending serotonin terminating in anterior horn cells The change of serotonin receptor activity of the source pathway.