Nikkheslat Naghmeh
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, UK.
Brain Behav Immun Health. 2021 Nov 10;18:100383. doi: 10.1016/j.bbih.2021.100383. eCollection 2021 Dec.
Major depressive disorder (MDD) is a common psychiatric disorder with multifactorial aetiology and complex pathophysiology. Despite availability of various pharmacological and non-pharmacological therapeutic strategies, treatment resistant depression (TRD) remains a significant challenge with specific concern for those patients with severe depressive symptoms in particular suicidal ideations who require immediate and effective intervention. Inflammation has been widely studied for its association with MDD and treatment response. Ketamine known as a dissociative anaesthetic has a novel rapid-acting antidepressant effect at lower doses. Anti-inflammatory actions of ketamine appear to play a role in mechanisms underlying its antidepressant effects. Considering the rapid antidepressant action of ketamine, this review provides a brief overview of antidepressant properties of ketamine as well as its effects on peripheral and central inflammation to better understand the mechanisms underlying the therapeutic action of ketamine as an anti-inflammatory antidepressant target in psychiatric emergency. Development of effective medications, which act rapidly with dual effect on both inflammation and MDD would be of a significant clinical importance for a successful and personalised treatment of inflammatory-induced TRD and suicidal thoughts and behaviour.
重度抑郁症（MDD）是一种常见的精神疾病，病因多因素且病理生理复杂。尽管有各种药物和非药物治疗策略，但难治性抑郁症（TRD）仍然是一个重大挑战，对于那些有严重抑郁症状尤其是有自杀意念的患者而言，他们需要立即且有效的干预，这一挑战尤为突出。炎症与MDD及治疗反应之间的关联已得到广泛研究。氯胺酮作为一种解离麻醉剂，在较低剂量时具有新型快速起效的抗抑郁作用。氯胺酮的抗炎作用似乎在其抗抑郁作用的潜在机制中发挥作用。鉴于氯胺酮的快速抗抑郁作用，本综述简要概述了氯胺酮的抗抑郁特性及其对外周和中枢炎症的影响，以便更好地理解氯胺酮作为精神科急诊中抗炎抗抑郁靶点的治疗作用机制。开发对炎症和MDD都有双重快速作用的有效药物，对于成功且个性化地治疗炎症诱导的TRD以及自杀念头和行为具有重要的临床意义。
