Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
Department of Psychiatry, Mayo Clinic, Rochester, Minnesota.
JAMA Psychiatry. 2017 Apr 1;74(4):399-405. doi: 10.1001/jamapsychiatry.2017.0080.
Several studies now provide evidence of ketamine hydrochloride's ability to produce rapid and robust antidepressant effects in patients with mood and anxiety disorders that were previously resistant to treatment. Despite the relatively small sample sizes, lack of longer-term data on efficacy, and limited data on safety provided by these studies, they have led to increased use of ketamine as an off-label treatment for mood and other psychiatric disorders.
This review and consensus statement provides a general overview of the data on the use of ketamine for the treatment of mood disorders and highlights the limitations of the existing knowledge. While ketamine may be beneficial to some patients with mood disorders, it is important to consider the limitations of the available data and the potential risk associated with the drug when considering the treatment option.
The suggestions provided are intended to facilitate clinical decision making and encourage an evidence-based approach to using ketamine in the treatment of psychiatric disorders considering the limited information that is currently available. This article provides information on potentially important issues related to the off-label treatment approach that should be considered to help ensure patient safety.
现在有几项研究提供了证据，证明盐酸氯胺酮能够快速而显著地治疗以前对治疗有抵抗的情绪和焦虑障碍患者。 尽管这些研究的样本量相对较小，缺乏关于疗效的长期数据，以及关于安全性的有限数据，但它们导致了氯胺酮作为情绪和其他精神障碍的标签外治疗的使用增加。
本综述和共识声明提供了关于氯胺酮治疗情绪障碍的数据的一般概述，并强调了现有知识的局限性。 虽然氯胺酮可能对一些情绪障碍患者有益，但在考虑治疗选择时，考虑到现有数据的局限性和与药物相关的潜在风险非常重要。
提供的建议旨在促进临床决策，并鼓励在考虑目前可用的有限信息的情况下，采用基于证据的方法使用氯胺酮治疗精神障碍。 本文提供了有关标签外治疗方法的潜在重要问题的信息，这些问题应予以考虑，以帮助确保患者安全。
