Tian Haihua, Hu Zhenyu, Xu Jia, Wang Chuang
Ningbo Key Laboratory of Behavioral Neuroscience Ningbo University School of Medicine Ningbo Zhejiang China.
Zhejiang Provincial Key Laboratory of Pathophysiology School of Medicine Ningbo University Ningbo Zhejiang China.
MedComm (2020). 2022 Jul 21;3(3):e156. doi: 10.1002/mco2.156. eCollection 2022 Sep.
Major depressive disorder (MDD) is a highly prevalent and disabling disorder. Despite the many hypotheses proposed to understand the molecular pathophysiology of depression, it is still unclear. Current treatments for depression are inadequate for many individuals, because of limited effectiveness, delayed efficacy (usually two weeks), and side effects. Consequently, novel drugs with increased speed of action and effectiveness are required. Ketamine has shown to have rapid, reliable, and long-lasting antidepressant effects in treatment-resistant MDD patients and represent a breakthrough therapy for patients with MDD; however, concerns regarding its efficacy, potential misuse, and side effects remain. In this review, we aimed to summarize molecular mechanisms and pharmacological treatments for depression. We focused on the fast antidepressant treatment and clarified the safety, tolerability, and efficacy of ketamine and its metabolites for the MDD treatment, along with a review of the potential pharmacological mechanisms, research challenges, and future clinical prospects.
重度抑郁症（MDD）是一种高度流行且使人致残的疾病。尽管为理解抑郁症的分子病理生理学提出了许多假说，但仍不清楚。目前针对抑郁症的治疗方法对许多患者来说并不充分，原因在于疗效有限、起效延迟（通常为两周）以及存在副作用。因此，需要具有更快起效速度和更高疗效的新型药物。氯胺酮已显示出对难治性MDD患者具有快速、可靠且持久的抗抑郁作用，代表了MDD患者的一种突破性治疗方法；然而，对其疗效、潜在滥用情况和副作用的担忧依然存在。在本综述中，我们旨在总结抑郁症的分子机制和药物治疗方法。我们聚焦于快速抗抑郁治疗，并阐明氯胺酮及其代谢产物用于MDD治疗的安全性、耐受性和疗效，同时综述潜在的药理机制、研究挑战和未来的临床前景。
