Chilukuri Harihar, Reddy Narasimha Pothula, Pathapati Ram Mohan, Manu Arkalgud Nagesha, Jollu Sharada, Shaik Ahammed Basha
Department of Psychiatry, Malla Reddy Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India.
Department of Anaesthesia, Narayana Medical College, Nellore, Andhra Pradesh, India.
Indian J Psychol Med. 2014 Jan;36(1):71-6. doi: 10.4103/0253-7176.127258.
Conventional antidepressants take two weeks before their therapeutic action begins. Recent studies have reported on the rapid antidepressant effect of ketamine when given as an intravenous (I.V.) infusion. Little is known about its intramuscular (I.M.) use in depression. Hence this study was conducted to compare the safety, tolerability and efficacy of I.M. versus. I.V. ketamine in Major Depression (ICD-10).
It was a randomized open label parallel group study in a tertiary care teaching hospital. Study sample consisted of 27 subjects having major depression divided randomly into three groups of nine subjects each. Ketamine administered to each group in the dose of 0.5 mg/kg as an I.V. infusion, as 0.5 mg/kg I.M. or 0.25 mg/kg I.M. respectively. Depression rated on the Hamilton Depression Rating Scale (HAM-D) before the injection, two hours later, the next day, and after three days. Data analyzed using the Statistical Package for Social Sciences (SPSS).
Mean age of the sample was 36.81 years (SD 11.815). Two hours after the injection, HAM-D fell by 58.86%, 60.29% & 57.36% in each group respectively. The improvement was sustained for next three days. Adverse effects noticed were rare, of mild nature and transient, lasting less than an hour.
Intramuscular ketamine in the dose of 0.25 mg/kg is as effective and safe as 0.5 mg/kg given either I.M. or I.V., substantially alleviating depressive symptoms within a few hours and sustained for 3 days.
传统抗抑郁药在开始治疗作用前需要两周时间。最近的研究报道了静脉注射氯胺酮时的快速抗抑郁作用。关于其在抑郁症中的肌肉注射使用情况知之甚少。因此，本研究旨在比较肌肉注射与静脉注射氯胺酮在重度抑郁症（ICD - 10）中的安全性、耐受性和疗效。
这是一项在三级护理教学医院进行的随机开放标签平行组研究。研究样本包括27名重度抑郁症患者，随机分为三组，每组9名受试者。分别以0.5mg/kg的剂量对每组进行静脉输注、0.5mg/kg肌肉注射或0.25mg/kg肌肉注射氯胺酮。在注射前、两小时后、次日及三天后使用汉密尔顿抑郁量表（HAM - D）对抑郁程度进行评分。使用社会科学统计软件包（SPSS）进行数据分析。
样本的平均年龄为36.81岁（标准差11.815）。注射两小时后，每组的HAM - D分别下降了58.86%、60.29%和57.36%。这种改善在接下来的三天内持续。观察到的不良反应很少，性质轻微且短暂，持续时间不到一小时。
0.25mg/kg剂量的肌肉注射氯胺酮与0.5mg/kg肌肉注射或静脉注射的氯胺酮一样有效且安全，能在数小时内显著减轻抑郁症状，并持续三天。
