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№ 1 (2024)

ПСИХОФАРМАКОТЕРАПИЯ

Психофармакотерапия в подростковом возрасте: нейробиологические предпосылки отдаленных последствий

https://doi.org/10.21265/PSYPH.2024.70.82.005

Опубликован 2024-03-30

  • М.Ю. Попов

М.Ю. Попов
ФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. Бехтерева» Министерства здравоохранения Российской Федерации

Аннотация

На протяжении последних десятилетий частота назначения психофармакологических препаратов пациентам подросткового возраста значительно увеличилась, что определяет актуальность вопросов, связанных с отдаленными последствиями психофармакотерапии. Цель работы — проанализировать и обобщить имеющиеся нейробиологические данные для оценки рисков отдаленных последствий воздействия на центральную нервную систему (ЦНС), связанных с приемом психофармакологических препаратов в подростковом возрасте. В статье рассмотрены процессы нейробиологического развития головного мозга на протяжении подросткового периода, обсуждена роль моноаминовых систем в регуляции этих процессов, приведены результаты релевантных экспериментальных исследований. С одной стороны, в своей совокупности имеющиеся данные указывают на то, что препараты, изменяющие активность моноаминергической передачи (в частности, антидепрессанты и антипсихотики), могут потенциально влиять на нормальное развитие и дальнейшее функционирование ЦНС. С другой стороны, эти же препараты гипотетически могут оказывать и «защитное» действие, компенсируя эндогенно и/или экзогенно обусловленные моноаминергические дисфункции, критичные для нормального развития ЦНС в определенные возрастные периоды. Результирующий эффект воздействия моноаминергических препаратов на развивающийся мозг определяется тремя основными факторами: этапом онтогенеза, на котором оказано воздействие; моноаминовой системой, на которую оказано воздействие; направленностью вектора воздействия (снижение либо усиление нейротрансмиссии). Трансляция нейробиологических и экспериментальных данных в клиническую практику требует проведения дальнейших исследований, в том числе направленных на поиск генетических и эпигенетических биомаркеров для разработки будущих алгоритмов персонализированной фармакотерапии психических расстройств в подростковом возрасте.

Ключевые слова

подростковый возраст, психофармакотерапия, антидепрессанты, антипсихотики, моноамины, развитие центральной нервной системы

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