精神疾病的神经生物学基础

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1、精神疾病的神经生物学基础及精神病药物作用机理abnormalgeneINHERITEDDISEASE100%willdeveloptheinheriteddisease(classicalautosomaldominantpattern)4-1StahlSM,EssentialPsychopharmacology(2000)abnormalgeneproductRISKFACTOR1anenzymeistoosloweversincebirthsoitishardtometabolizeneurotransmitterswhenreleaseisveryfastRI

2、SKFACTOR2someneuronsmigratedtoofarduringdevelopmentinuteroRISKFACTOR3someofthewrongsynapseswereeliminatedinadolescenceRISKFACTOR4nervesfiretoofastwhenyouseeyourmother1-3areinheritedgenetic“hits”-4&5areenvironmental“hits”expressedthroughabnormalgeneticresponsesRISKFACTOR5nervesfiretoofa

3、stwhenyoutake“speed”4-2StahlSM,EssentialPsychopharmacology(2000)LIFEEVENTSFILTERpersonality/copingskillsgeneticvulnerabilityfactorsfordepression4-3StahlSM,EssentialPsychopharmacology(2000)evenifyouinheritthegeneforSchizophrenia,thechancesofwhetherornotyoudevelopthediseasemaybeaffectedb

4、youtsidefactorsbadchildhooddivorcevirusortoxinschizophrenia4-4StahlSM,EssentialPsychopharmacology(2000)MINORSTRESSORS(DNAwithpredispositionforschizophrenia--highlybiologicallydetermined)SCHIZOPHRENIAMODERATESTRESSORS(DNAwithpredispositionfordepression--moderatelybiologicallydetermined)

5、DEPRESSIONMAJORSTRESSORS(“normal”DNA)PTSD4-5StahlSM,EssentialPsychopharmacology(2000)goodneuronalselection=healthyneuron=defectiveneuronbadneuronalselection4-6StahlSM,EssentialPsychopharmacology(2000)badmigrationgoodmigration4-7StahlSM,EssentialPsychopharmacology(2000)CORRECTWIRING4-8S

6、tahlSM,EssentialPsychopharmacology(2000)WRONGWIRING4-9StahlSM,EssentialPsychopharmacology(2000)normaldevelopmentadultdegenerativedisease4-10StahlSM,EssentialPsychopharmacology(2000)undevelopedneurondevelopmentaldiseaseornostimulation4-11StahlSM,EssentialPsychopharmacology(2000)growthfa

7、ctor(protein)4-12StahlSM,EssentialPsychopharmacology(2000)growthfactor(protein)4-13StahlSM,EssentialPsychopharmacology(2000)Newneuronisimplantedtotakeoverthefunctionsofthedeadneuron4-14StahlSM,EssentialPsychopharmacology(2000)=calciumCalciumenteringneuronatanormalrateCalciumenteringn