Berman R M, Cappiello A, Anand A, Oren D A, Heninger G R, Charney D S, Krystal J H
Abraham Ribicoff Center Clinical Neuroscience Research Unit of the Connecticut Mental Health Center, New Haven 06519, USA.
Biol Psychiatry. 2000 Feb 15;47(4):351-4. doi: 10.1016/s0006-3223(99)00230-9.
A growing body of preclinical research suggests that brain glutamate systems may be involved in the pathophysiology of major depression and the mechanism of action of antidepressants. This is the first placebo-controlled, double-blinded trial to assess the treatment effects of a single dose of an N-methyl-D-aspartate (NMDA) receptor antagonist in patients with depression.
Seven subjects with major depression completed 2 test days that involved intravenous treatment with ketamine hydrochloride (.5 mg/kg) or saline solutions under randomized, double-blind conditions.
Subjects with depression evidenced significant improvement in depressive symptoms within 72 hours after ketamine but not placebo infusion (i.e., mean 25-item Hamilton Depression Rating Scale scores decreased by 14 +/- SD 10 points vs. 0 +/- 12 points, respectively during active and sham treatment).
These results suggest a potential role for NMDA receptor-modulating drugs in the treatment of depression.
越来越多的临床前研究表明，大脑谷氨酸系统可能参与重度抑郁症的病理生理学过程以及抗抑郁药的作用机制。这是第一项评估单剂量N-甲基-D-天冬氨酸（NMDA）受体拮抗剂对抑郁症患者治疗效果的安慰剂对照、双盲试验。
7名重度抑郁症患者在随机、双盲条件下完成了2个测试日，涉及静脉注射盐酸氯胺酮（0.5毫克/千克）或生理盐水。
抑郁症患者在注射氯胺酮后72小时内抑郁症状有显著改善，而注射安慰剂后则无改善（即，在积极治疗和假治疗期间，25项汉密尔顿抑郁量表平均得分分别下降了14±标准差10分和0±12分）。
这些结果表明NMDA受体调节药物在抑郁症治疗中可能发挥作用。
