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Glutamatergic medications for the treatment of drug and behavioral addictions

机译：谷氨酸能药物治疗药物和行为成瘾

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摘要

Historically, most pharmacological approaches to the treatment of addictive disorders have utilized either substitution-based methods (i.e., nicotine replacement or opioid maintenance) or have targeted monoaminergic or endogenous opioidergic neurotransmitter systems. However, substantial evidence has accumulated indicating that ligands acting on glutamatergic transmission are also of potential utility in the treatment of drug addiction, as well as various behavioral addictions such as pathological gambling. The purpose of this review is to summarize the pharmacological mechanisms of action and general clinical efficacy of glutamatergic medications that are currently approved or are being investigated for approval for the treatment of addictive disorders. Medications with effects on glutamatergic transmission that will be discussed include acamprosate, N-acetylcysteine, d-cycloserine, gabapentin, lamotrigine, memantine, modafinil, and topiramate. We conclude that manipulation of glutamatergic neurotransmission is a relatively young but promising avenue for the development of improved therapeutic agents for the treatment of drug and behavioral addictions.
机译：从历史上看，大多数治疗成瘾性疾病的药理方法都采用基于取代的方法（即尼古丁替代或阿片类药物维持）或靶向单胺能或内源性阿片类神经递质系统。但是，大量证据表明，作用于谷氨酸能传递的配体在治疗药物成瘾以及各种行为成瘾（例如病理性赌博）方面也具有潜在的效用。这篇综述的目的是总结目前已经批准或正在研究批准用于治疗成瘾性疾病的谷氨酸能药物的药理作用机理和一般临床疗效。将讨论对谷氨酸能传递有影响的药物包括阿坎酸，N-乙酰半胱氨酸，d-环丝氨酸，加巴喷丁，拉莫三嗪，美金刚，莫达非尼和托吡酯。我们得出的结论是，操纵谷氨酸能神经传递是相对年轻但有希望的途径，用于开发用于治疗药物和行为成瘾的改良治疗剂。

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