Rothärmel Maud, Benosman Cherifa, El-Hage Wissam, Berjamin Caroline, Ribayrol Diane, Guillin Olivier, Gaillard Raphaël, Berkovitch Lucie, Moulier Virginie
Service Hospitalo-Universitaire de Psychiatrie, Centre d'Excellence Thérapeutique-Institut de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville-lès-Rouen, France.
Centre Régional de Psychotraumatologie, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, France.
Front Psychiatry. 2022 Jul 8;13:865466. doi: 10.3389/fpsyt.2022.865466. eCollection 2022.
Major depressive disorder (MDD) is more likely to resist to usual treatment when it is associated with post-traumatic stress disorder (PTSD). Capitalizing on the effect of ketamine in both treatment-resistant depression (TRD) and PTSD, we conducted a study in order to assess the efficacy of intranasal (IN) Esketamine in patients having TRD with comorbid PTSD.
In this open-label, single arm, retrospective pilot study, 11 patients were treated with IN Esketamine (56 or 84 mg) with a longitudinal follow-up of 6 months. IN Esketamine was administered twice weekly during the first month, once weekly during the second month, and then once every 1 or 2 weeks. Patients were assessed with Montgomery-Åsberg Depression Rating Scale (MADRS), Patient Health Questionnaire 9 items, Global Assessment of Functioning (GAF), and Clinical Global Impression-Suicide Scale (CGI-SS).
We included 9 women and 2 men (mean age 47.3 ± 11.1 years). The mean (SD) MADRS scores decreased significantly from 38.6 (6.4) at baseline to 18.2 (10.03) after 6 months of IN Esketamine; 7 patients were responders and 3 patients were in remission. The percentage of patients who were moderately to severely suicidal declined from 63.6% at baseline to 27.3% after 1 month of IN Esketamine sessions. No serious adverse reactions were observed.
This study reports the outcomes of 11 severely ill patients with comorbid TRD and PTSD after IN Esketamine treatment. Esketamine significantly improved depression symptoms, suggesting that it is likely to be a treatment of choice in this specific population.
重度抑郁症（MDD）与创伤后应激障碍（PTSD）共病时更有可能对常规治疗产生抵抗。鉴于氯胺酮对难治性抑郁症（TRD）和PTSD均有疗效，我们开展了一项研究，以评估鼻内（IN）艾氯胺酮对伴有PTSD共病的TRD患者的疗效。
在这项开放标签、单臂、回顾性试点研究中，11例患者接受了IN艾氯胺酮（56或84毫克）治疗，并进行了为期6个月的纵向随访。IN艾氯胺酮在第一个月每周给药两次，第二个月每周给药一次，然后每1或2周给药一次。使用蒙哥马利-Åsberg抑郁评定量表（MADRS）、患者健康问卷9项、功能总体评定量表（GAF）和临床总体印象-自杀量表（CGI-SS）对患者进行评估。
我们纳入了9名女性和2名男性（平均年龄47.3±11.1岁）。平均（标准差）MADRS评分从基线时的38.6（6.4）显著降至IN艾氯胺酮治疗6个月后的18.2（10.03）；7例患者有反应，3例患者缓解。中度至重度自杀倾向患者的比例从基线时的63.6%降至IN艾氯胺酮治疗1个月后的27.3%。未观察到严重不良反应。
本研究报告了11例患有TRD和PTSD共病的重症患者接受IN艾氯胺酮治疗后的结果。艾氯胺酮显著改善了抑郁症状，表明它可能是这一特定人群的首选治疗方法。
