Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
World J Biol Psychiatry. 2009;10(3):241-4. doi: 10.1080/15622970701714370.
Recent studies with intravenous infusion of the NMDA receptor antagonist ketamine showed robust and rapid antidepressant effects within hours after treatment. Ketamine is a racemic mixture consisting of two enantiomers, R- and S-ketamine. In contrast to ketamine, S-ketamine is reported to be less prone to psychomimetic side effects, such as derealisation and hallucinations. In this report we describe the effect of ketamine and S-ketamine infusion therapy, respectively, in two patients with treatment-resistant major depression. Severity of depression was rated using the Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI). While one patient did not respond to either treatment, in the other patient intravenous administration of ketamine as well as S-ketamine showed an antidepressant effect as assessed by a decrease in HAMD-21 and BDI at days 1 and 3 after infusion which faded until day 6. Both patients experienced psychomimetic side effects during ketamine infusion which were absent during treatment with S-ketamine. We conclude that S-ketamine might exert similar antidepressant effects as ketamine in drug-resistant depression but may be better tolerated by the patients.
最近的研究表明，静脉输注 NMDA 受体拮抗剂氯胺酮在治疗后数小时内即可产生强大而快速的抗抑郁作用。氯胺酮是一种由两种对映异构体 R-和 S-氯胺酮组成的外消旋混合物。与氯胺酮相比，S-氯胺酮据报道较少引起精神拟态副作用，如现实解体和幻觉。在本报告中，我们分别描述了氯胺酮和 S-氯胺酮输注治疗在两名治疗抵抗性重度抑郁症患者中的效果。使用汉密尔顿抑郁评定量表（HAMD）和贝克抑郁量表（BDI）评估抑郁严重程度。虽然一名患者对两种治疗均无反应，但另一名患者静脉注射氯胺酮和 S-氯胺酮均显示出抗抑郁作用，在输注后第 1 天和第 3 天 HAMD-21 和 BDI 下降，直到第 6 天才消退。两名患者在氯胺酮输注期间均出现精神拟态副作用，而在 S-氯胺酮治疗期间则没有。我们得出结论，S-氯胺酮可能在耐药性抑郁症中产生与氯胺酮相似的抗抑郁作用，但可能更能耐受患者。
