Graduate of the Medical University of Łódz, F. Marciniaka 16, 63-500 Ostrzeszów, Poland,
Psychiatr Danub. 2021 Winter;33(4):468-474. doi: 10.24869/psyd.2021.468.
Depression is one of the most common mental disorders. Currently used antidepressants, acting on the monoaminergic system, are insufficient for depression treatment. In recent years, potential application of NMDA receptor modulators in the treatment of drug-resistant depression has gained attention. Administration of ketamine, being a non-competitive NMDA receptor antagonist, contributes to a faster remission of symptoms.
The aim of this paper is to review current studies on the use of ketamine in the treatment of drug-resistant depression, compare results of various administration methods - intravenous, intranasal or oral, as well as compare its effectiveness with that of other antidepressants.
Numerous studies show the drug is effective and well tolerated, particularly in patients with increased suicidal thoughts. However, there are concerns on increasing tolerance to the drug and the possibility of implementing a long-term treatment.
Oral and intranasal forms of the drug are particularly promising due to their non-invasiveness and ability to self-administer. In March 2019, S-ketamine nasal spray was registered by the FDA for the treatment of drug-resistant depression.
抑郁症是最常见的精神障碍之一。目前使用的抗抑郁药作用于单胺能系统，对于治疗抑郁症效果不足。近年来，NMDA 受体调节剂在治疗耐药性抑郁症方面的潜在应用引起了关注。氯胺酮作为一种非竞争性 NMDA 受体拮抗剂，有助于更快地缓解症状。
本文旨在综述氯胺酮在治疗耐药性抑郁症中的应用的现有研究，比较各种给药方式（静脉内、鼻内或口服）的结果，并比较其与其他抗抑郁药的疗效。
大量研究表明该药物有效且耐受性良好，特别是对于有自杀意念增加的患者。然而，人们担心药物的耐受性增加以及实施长期治疗的可能性。
由于其非侵入性和自我给药的能力，药物的口服和鼻内形式特别有前途。2019 年 3 月，FDA 批准 S-氯胺酮鼻喷雾剂用于治疗耐药性抑郁症。
