Rengasamy Manivel, Hsiung Kimberly, Price Rebecca B
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
University of Pittsburgh School of Medicine, Pittsburgh, PA.
Curr Behav Neurosci Rep. 2019 Dec;6(4):166-176. doi: 10.1007/s40473-019-00184-3. Epub 2019 Dec 2.
Given recent increases in rates of suicide and lack of rapid treatments for suicidality, ketamine has been identified as a potential fast-acting anti-suicidal treatment. Our review seeks to describe the effects of ketamine on suicidality, given the growing literature on the use of ketamine in reducing suicidality. We examine open-label studies and randomized controlled trials evaluating treatment of suicidality with ketamine. Furthermore, our manuscript identifies potential mechanisms of ketamine's effects on suicidality.
Based on existing RCTs, ketamine appears to have rapid anti-suicidal effects, with most literature studying such effects in timeframes less than one week. Although still in the early stages of research, mechanisms of ketamine include modulation of molecular, inflammatory, neural, cognitive, and behavioral processes.
Thus, ketamine appears to be a promising treatment for suicidality, but requires larger scale and more robust RCTs to confirm the potential use of this agent in clinical settings.
鉴于近期自杀率上升且缺乏针对自杀倾向的快速治疗方法，氯胺酮已被确定为一种潜在的快速起效的抗自杀治疗药物。鉴于关于氯胺酮用于降低自杀倾向的文献不断增加，我们的综述旨在描述氯胺酮对自杀倾向的影响。我们审查了评估氯胺酮治疗自杀倾向的开放标签研究和随机对照试验。此外，我们的手稿确定了氯胺酮对自杀倾向影响的潜在机制。
基于现有的随机对照试验，氯胺酮似乎具有快速的抗自杀作用，大多数文献在不到一周的时间内研究这种作用。尽管仍处于研究初期，但氯胺酮的作用机制包括分子、炎症、神经、认知和行为过程的调节。
因此，氯胺酮似乎是一种有前景的自杀倾向治疗药物，但需要更大规模、更有力的随机对照试验来证实该药物在临床环境中的潜在用途。
