[氯胺酮治疗急性重度重度抑郁症]
[Ketamine in acute and severe major depressive disorder].
作者信息
Brittner Marie, Micoulaud-Franchi Jean-Arthur, Richieri Raphaelle, Boyer L, Adida Marc, Lancon Christophe, Fond Guilllaume
机构信息
CHU de Montpellier, université Montpellier 1, service universitaire de psychiatrie, Inserm 1061, 34000 Montpellier, France.
Hôpital Sainte-Marguerite, service hospitalo-universitaire de psychiatrie, 13009 Marseille, France.
出版信息
Presse Med. 2014 May;43(5):492-500. doi: 10.1016/j.lpm.2013.11.013. Epub 2014 Mar 12.
CONTEXT
Depression is a frequent, severe and expensive illness. Approximately 20% of depressive episodes are resistant to classic antidepressants. Glutamatergic antagonists, in particular ketamine, established a new, rapid and robust therapeutic approach in resistant depression.
RESULTS
The main results in the literature show a rapid and robust antidepressant effect of ketamine, with infra-anesthesic posology (0.5mg/kg) administered in intravenous way. Positive effects are observed on depressive symptoms, suicidal thoughts, and there is a potential synergic action when used in the induction of anesthesia for electroconvulsive therapy. However, effects only last shortly. Side effects are mostly reversible and of mild intensity, no severe consequences were reported.
LIMITS
Limits are the lack of power of the included studies, due to small sample sizes, and the scarcity of studies. Misuse of ketamine is an important issue to be taken into account, and few data about ketamine addiction potential and its long-term effects are published at the moment.
背景
抑郁症是一种常见、严重且花费高昂的疾病。约20%的抑郁发作对经典抗抑郁药耐药。谷氨酸能拮抗剂，尤其是氯胺酮，为耐药性抑郁症建立了一种新的、快速且有效的治疗方法。
结果
文献中的主要结果显示，静脉注射亚麻醉剂量（0.5mg/kg）的氯胺酮具有快速且显著的抗抑郁作用。在抑郁症状、自杀念头方面观察到积极效果，并且在用于电休克治疗的麻醉诱导时存在潜在协同作用。然而，效果仅持续短暂时间。副作用大多可逆且强度轻微，未报告严重后果。
局限性
局限性在于纳入研究样本量小导致研究效能不足，以及研究稀缺。氯胺酮的滥用是一个需要考虑的重要问题，目前关于氯胺酮成瘾潜力及其长期影响的数据很少。
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