Department of Psychiatry, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, South Kargar Street, Tehran 13337-95914, Iran; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, P.O. Box 13145-784, Tehran, Iran; NeurExpand Brain Center, 1205 York Road, Lutherville, MD 21093, USA.
Department of Psychiatry, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, South Kargar Street, Tehran 13337-95914, Iran; Robert S. Boas Center for Genomics and Human Genetics, The Feinstein Institute for Medical Research (FIMR), Manhasset, NY, USA.
Psychiatry Res. 2014 Feb 28;215(2):355-61. doi: 10.1016/j.psychres.2013.12.008. Epub 2013 Dec 13.
Accumulating evidence suggests that N-methyl-d-aspartate receptor (NMDAR) antagonists (e.g. ketamine) may exert rapid antidepressant effects in MDD patients. In the present study, we evaluated the rapid antidepressant effects of ketamine compared with the electroconvulsive therapy (ECT) in hospitalized patients with MDD. In this blind, randomized study, 18 patients with DSM-IV MDD were divided into two groups which received either three intravenous infusions of ketamine hydrochloride (0.5 mg/kg over 45 min) or ECT on 3 test days (every 48 h). The primary outcome measure was the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS), which was used to rate overall depressive symptoms at baseline, 24 h after each treatment, 72 h and one week after the last (third) ketamine or ECT. Within 24 h, depressive symptoms significantly improved in subjects receiving the first dose of ketamine compared with ECT group. Compared to baseline level, this improvement remained significant throughout the study. Depressive symptoms after the second dose ketamine was also lower than the second ECT. This study showed that ketamine is as effective as ECT in improving depressive symptoms in MDD patients and have more rapid antidepressant effects compared with the ECT.
越来越多的证据表明，N-甲基-D-天冬氨酸受体（NMDAR）拮抗剂（如氯胺酮）可能对 MDD 患者产生快速抗抑郁作用。在本研究中，我们评估了氯胺酮与电抽搐治疗（ECT）在住院 MDD 患者中的快速抗抑郁作用。在这项盲法、随机研究中，18 名符合 DSM-IV 标准的 MDD 患者被分为两组，分别接受 3 次静脉注射盐酸氯胺酮（0.5mg/kg，持续 45 分钟）或 3 个测试日（每 48 小时）的 ECT。主要观察指标为贝克抑郁量表（BDI）和汉密尔顿抑郁量表（HDRS），用于评估基线时、每次治疗后 24 小时、72 小时和最后一次（第三次）氯胺酮或 ECT 后一周的总体抑郁症状。在 24 小时内，接受首剂氯胺酮的受试者的抑郁症状明显改善，与 ECT 组相比。与基线水平相比，这种改善在整个研究过程中仍然显著。接受第二剂氯胺酮后，抑郁症状也低于第二次 ECT。这项研究表明，氯胺酮在改善 MDD 患者的抑郁症状方面与 ECT 一样有效，并且与 ECT 相比具有更快的抗抑郁作用。
