Department of Anatomy and Cell Biology, McGill University, Montreal, Canada.
McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Canada.
Int J Neuropsychopharmacol. 2022 Jan 12;25(1):75-84. doi: 10.1093/ijnp/pyab082.
Major depressive disorder (MDD) is a common psychiatric illness that manifests in sex-influenced ways. Men and women may experience depression differently and also respond to various antidepressant treatments in sex-influenced ways. Ketamine, which is now being used as a rapid-acting antidepressant, is likely the same. To date, the majority of studies investigating treatment outcomes in MDD do not disaggregate the findings in males and females, and this is also true for ketamine. This review aims to highlight that gap by exploring pre-clinical data-at a behavioral, molecular, and structural level-and recent clinical trials. Sex hormones, particularly estrogen and progesterone, influence the response at all levels examined, and sex is therefore a critical factor to examine when looking at ketamine response. Taken together, the data show females are more sensitive to ketamine than males, and it might be possible to monitor the phase of the menstrual cycle to mitigate some risks associated with the use of ketamine for females with MDD. Based on the studies reviewed in this article, we suggest that ketamine should be administered adhering to sex-specific considerations.
重度抑郁症（MDD）是一种常见的精神疾病，其表现方式具有性别差异。男性和女性可能以不同的方式经历抑郁症，并且对各种抗抑郁治疗的反应也不同。氯胺酮，现在被用作一种快速起效的抗抑郁药，也可能是这样。迄今为止，大多数研究抗抑郁治疗结果的研究都没有对男性和女性的研究结果进行细分，氯胺酮也是如此。本综述旨在通过探索临床前数据——在行为、分子和结构水平——和最近的临床试验来突出这一差距。性激素，特别是雌激素和孕激素，影响所有检查水平的反应，因此，在研究氯胺酮反应时，性别是一个关键因素。综上所述，数据表明女性对氯胺酮比男性更敏感，并且有可能通过监测月经周期的阶段来减轻女性 MDD 使用氯胺酮的一些风险。基于本文综述的研究，我们建议根据性别差异考虑因素来给予氯胺酮。
