氯胺酮对抑郁和睡眠障碍的快速作用机制：一篇叙述性综述
Mechanisms of the Rapid Effects of Ketamine on Depression and Sleep Disturbances: A Narrative Review.
作者信息
Song Bijia, Zhu Jun-Chao
机构信息
Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China.
出版信息
Front Pharmacol. 2021 Dec 14;12:782457. doi: 10.3389/fphar.2021.782457. eCollection 2021.
Abstract
Recently, sleep has been recognized as a crucial factor for health and longevity. The daily sleep/wake cycle provides the basis of biorhythm, which controls whole-body homeostasis and homeodynamics. Sleep disturbances can contribute to several physical and psychological disorders, including cardiovascular disease, obesity, depression, and cognitive dysfunction. The clinical use of the N-methyl-D-aspartate (NMDA) receptor antagonist ketamine began in the 1970s. Over the years, physicians have used it as a short-acting anesthetic, analgesic, and antidepressant; however, in-depth research has revealed new possible applications for ketamine, such as for treating sleep disturbances and circadian rhythm disorders. The aim of this narrative review is to examine the literature on the mechanistic role of the antidepressant ketamine in affecting sleep disturbance. Additionally, we discuss the pharmacologic and pharmacokinetic mechanisms of ketamine as an antidepressant and the predictive biomarkers for ketamine's effect on sleep and cognitive function.
摘要
最近，睡眠已被公认为健康和长寿的关键因素。每日的睡眠/觉醒周期是生物节律的基础，它控制着全身的内稳态和动态平衡。睡眠障碍会导致多种身心疾病，包括心血管疾病、肥胖症、抑郁症和认知功能障碍。N-甲基-D-天冬氨酸（NMDA）受体拮抗剂氯胺酮的临床应用始于20世纪70年代。多年来，医生们一直将其用作短效麻醉剂、镇痛药和抗抑郁药；然而，深入研究揭示了氯胺酮新的潜在应用，如治疗睡眠障碍和昼夜节律紊乱。本叙述性综述的目的是研究关于抗抑郁药氯胺酮在影响睡眠障碍方面的机制作用的文献。此外，我们还讨论了氯胺酮作为抗抑郁药的药理和药代动力学机制，以及氯胺酮对睡眠和认知功能影响的预测生物标志物。
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