Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Dębinki St. 7 build. 25, 80-952 Gdańsk, Poland,
Psychiatr Danub. 2019 Sep;31(Suppl 3):530-533.
Major depressive disorder (MDD) is a recurrent, incapacitating psychiatric illness which will be the second most disabling disease worldwide by the year 2020. There is a rising promise in a N-methyl-D-aspartate (NMDA) receptor antagonist, ketamine, which may be used in the treatment of resistant depression. Many of the studies are in favor of the drug, even in single dose application, with effects appearing in minutes to hours from administration. However, there is a need to evaluate the benefits and risks regarding psychomimetic, psychiatric, neurologic, and cognitive adverse effects of ketamine administration. The most distressing symptoms which appear most frequently during ketamine administration are dissociative symptoms, which can be quantified as a CNS adverse drug reaction. Results generally show that a single infusion of ketamine is efficacious and well-tolerated, while dissociative symptoms tend to abate within 2 hours after ketamine administration. As studies show single doses of ketamine should be definitely considered as an option in TRD patients with/without suicidal thoughts, even though it could not provide remission, or the effect could be temporary, but improving patients' quality of life by reducing depressive symptomatology should be a major asset while considering this particular procedure, particularly in inpatients.
重性抑郁障碍（MDD）是一种反复发作、使人丧失能力的精神疾病，到 2020 年，它将成为全球第二大致残疾病。N-甲基-D-天冬氨酸（NMDA）受体拮抗剂氯胺酮在治疗耐药性抑郁症方面有很大的希望。许多研究都支持这种药物，即使是单次应用，在给药后几分钟到几小时内就会出现效果。然而，需要评估氯胺酮给药的致幻、精神、神经和认知不良反应的益处和风险。在氯胺酮给药过程中最常见且最令人痛苦的症状是分离症状，这可以被量化为中枢神经系统不良反应。结果表明，单次输注氯胺酮是有效且耐受良好的，而分离症状在氯胺酮给药后 2 小时内趋于减轻。研究表明，对于有/无自杀念头的 TRD 患者，单次剂量的氯胺酮应该被明确考虑为一种选择，尽管它可能不会缓解症状，或者效果可能是暂时的，但通过减轻抑郁症状来提高患者的生活质量应该是一个主要的优势，特别是在住院患者中。
