Psychatlanta/Northwest Behavioral Research Center, 1012 Coggins Place NE, Marietta, GA 30060, United States.
Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA30912, United States.
CNS Spectr. 2020 Jun;25(3):331-342. doi: 10.1017/S1092852919001238. Epub 2019 Jul 24.
Anxiety disorders are among the most prevalent psychiatric conditions. Despite many proven pharmacological and non-pharmacological treatments available, high rates of partial response and low rates of long-term remission remain. Ketamine has been receiving increasing attention as an interventional treatment modality in psychiatry, especially among refractory conditions, including major depressive disorder. There is limited yet growing evidence to support the use of ketamine in anxiety disorders. In this review of the literature, we present case reports, case series, and controlled trials demonstrating proof-of-concept for its potential role in the treatment of anxiety and anxiety spectrum disorders. Its unique mechanism of action, rapid onset, and high rate of response have driven its use in clinical practice. Ketamine is generally well tolerated by patients and has a limited side effect profile; however, the effects of long-term use are unknown. While there is a growing body of research and increasing clinical experience to suggest ketamine may have clinical applications in the treatment of refractory anxiety disorders, further research to determine long-term safety and tolerability is indicated.
焦虑障碍是最常见的精神疾病之一。尽管有许多经过验证的药物和非药物治疗方法，但部分缓解率仍然很高，长期缓解率仍然很低。氯胺酮作为一种干预性治疗方式在精神病学中受到越来越多的关注，特别是在难治性疾病中，包括重度抑郁症。目前有有限但不断增加的证据支持氯胺酮在焦虑障碍中的应用。在对文献的回顾中，我们展示了病例报告、病例系列和对照试验，证明了它在治疗焦虑和焦虑谱系障碍方面的潜在作用。其独特的作用机制、快速起效和高反应率促使它在临床实践中得到应用。氯胺酮通常被患者耐受良好，副作用谱有限；然而，长期使用的效果尚不清楚。虽然越来越多的研究和越来越多的临床经验表明氯胺酮可能在治疗难治性焦虑障碍方面具有临床应用，但需要进一步研究以确定长期的安全性和耐受性。
