Liebrenz Michael, Borgeat Alain, Leisinger Ria, Stohler Rudolf
Psychiatric University Hospital, Research Group on Substance Use Disorders, Zurich, Switzerland.
Swiss Med Wkly. 2007 Apr 21;137(15-16):234-6. doi: 10.4414/smw.2007.11852.
Recently, reports from North America have indicated that the intravenous infusion of ketamine hydrochloride (an N-methyl-d-aspartate receptor antagonist) results in a sudden and robust improvement of depression symptoms.
To corroborate antidepressant effectiveness of IV ketamine in a patient with a co-occurring substance use disorder for the first time in a European clinical setting.
Open label trial Methods: A 55-year-old male subject with a treatment-resistant major depression and a co-occurring alcohol and benzodiazepine dependence received an intravenous infusion of 0.5 mg/kg ketamine over a period of 50 minutes. Effects were assessed by means of a clinical interview, the 21-item Hamilton Depression Rating scale (HDRS), and the 21-item Beck Depression Inventory (BDI) at baseline, 1 hour, 1 day, 2 days, and 7 days after intervention.
Following the administration of ketamine the subject experienced a significant improvement of his symptoms peaking on the 2nd day post infusion (HDRS from 36 to 16; -56.6%, BDI from 26 to 9; -65.4%). The subject first reported improvements 25 min. into the infusion and continued to describe positive effects throughout the subsequent 7 days.
Ketamine not only seems to have strong antidepressant effects but also to act very swiftly. These actions were unaffected by an alcohol or benzodiazpine dependence.
最近，来自北美的报告表明，静脉输注盐酸氯胺酮（一种N-甲基-D-天冬氨酸受体拮抗剂）可使抑郁症状突然且显著改善。
在欧洲临床环境中首次证实静脉注射氯胺酮对同时患有物质使用障碍的患者的抗抑郁效果。
开放标签试验
一名55岁男性受试者，患有难治性重度抑郁症，同时存在酒精和苯二氮䓬依赖，在50分钟内静脉输注0.5mg/kg氯胺酮。在干预前、干预后1小时、1天、2天和7天，通过临床访谈、21项汉密尔顿抑郁量表（HDRS）和21项贝克抑郁量表（BDI）评估效果。
给予氯胺酮后，受试者的症状有显著改善，在输注后第2天达到峰值（HDRS从36降至16；-56.6%，BDI从26降至9；-65.4%）。受试者在输注25分钟后首次报告症状改善，并在随后7天内持续描述积极效果。
氯胺酮不仅似乎具有强大的抗抑郁作用，而且起效非常迅速。这些作用不受酒精或苯二氮䓬依赖的影响。
