KISEP Special Articles 생물정신의학 Vol. 4, No. 2, December 1997 세로토닌과정신의학 양병환 * Serotonin in Psychiatry ByungHwan Yang, M.D., Ph.D.* ABSTRACT S erotonin has been implicated in the etiology of many disease states and may be particularly important mental illness, such as depression, anxiety, schizophrenia, sleep disorders, suicide, eating disorders, obsessive compulsive disorders, migraine and others. Many currently used treatments of these disorders are thought to act by modulating serotonergic function. The identification of many serotonin subtypes, most of which have been shown to have functional activity and differential distribution, has stimulated considerable effort into synthesizing selective ligandsdrugs to help understand their significance. This should understand the role of serotonin in mental disorders and these new drugs can be studied alone and in combination with other treatments in order to clarify the parameters of drug use for the clinical effect. KEY WORDSSerotoninMental disorderserotonin receptor subtypesselective serotonin receptor drugs. 서 론 Department of Neuropsychiatry, College of Medicine the Mental Health Research Institute, Hanyang University, Seoul, Korea - 155 -
Fig. 1. Structural relationships of the various indolealkyl amin Compound Substitutions Tryptamine R1 and R2H Serotoinin Tryptamine with 5 hydroxy DMT* R1 and R2methyl DET* R1 and R2ethyl Bufotenine* 5 hydroxy, DMT Szara psychotrope* 6 hydroxy, DET Psilocin* 4 hydroxy, DMT Harmaline* 6 methoxyr1 forms isopropyl link to C2 5-MT 5-methoxytryptamine 5, 6 DHT 5,6 dihydroxytryptamine 5, 7 DHT 5,7 dihydroxytryptamine *Pychotropic or behavioral effects 세로토닌계 Fig. 2. The metabolic pathways available for the synthesis and metabolism of serotoin. - 156 -
Fig. 3. Serotonergic pathways. 세로토닌과행동 (Behavior) Table 1. Clinical areas influenced by altered 5-HT function Affective disorders Substance abuse Anxiety disorders Pain sensitivity Obsessive-compulsive Emesis disorder Mycoclonis Schizophrenia Neuroendocrine regulation Eating disorders Circadian rhythm regulation Sleep disorders Stress disorders Sexual disorders Carcinoid syndrome Impulse disorders Developmental disorders Aging and neurodegenerative disorders Fig. 4. Influence of some serotonergic dimensions on diagnosis. AbbreviationsOCDobsessive compulsive disorder. PTSDposttraumatic stress disorder. - 157 -
세로토닌수용체아형 Table 2. Serotonin receptor chassification Effector Primary Subtype mechanism effector Brain locations 5-HT1A AC, K chanel Hippocampus, amygdalal, entorhinal cortex, raphe nuclei 5-HT1B AC Hippocampus, striatum, substantia nigra, rapha nuclei, cerebellum 5-HT1D AC Dorsal raphe nucleus 5-HT1D AC Hippocampus, striatum, substantia nigra, raphe nuclei, cerebellum 5-HT1E AC Cerebral cortex, putamen G protein coupled 5-HT1F AC Cerebral cortex, hippocampus, raphe nuclei, solitary tract nucleus 5-HT2A PI turnover Cerbral cortex, hippocampus, striatum 5-HT2B PI turnover Stomach fundus 5-HT2C PI turnover Choroid plexus, hippocampus, habenula, substantia nigra, locus coreruleus, raphe nuclei 5-HT4 AC Colliculi, hippocampus 5-HT5A Unknown Olfactory bulb, cerebral cortex, hippocampus, habenula, cerebellum 5-HT5B Unknown Hippocampus, habenula, raphe nuclei 5-HT6 AC Striatum, amygdala, cortex 5-HT7 AC Thalamus, hypothalamus Ligand-gated 5-HT3 ion channel Cation selective excitatory Olfactory bulb, cerebral cortex, hippocampus, amygdala, hypothalamus, solitary tract nucleus Note. ACadenylate cyclase activity PIphosphatidylinositol - 158 -
Fig. 5. A schematic diagram of aspects of serotonergic neurotransmission that could be modified by pharmacologic treatments or that may be altered in disease states. 세로토닌과임상장애 - 159 -
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