Veraart J K E, van Westenbrugge M, van Wulfften Palthe J E, van der Meij A, Schoevers R A, de Jong J
PsyQ Depression Treatment Centre, Parnassia Psychiatric Institute, The Hague, the Netherlands.
Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.
Heliyon. 2023 May 4;9(5):e15883. doi: 10.1016/j.heliyon.2023.e15883. eCollection 2023 May.
Ketamine and its S-enantiomer esketamine are novel pharmacotherapeutic options for treatment resistant depression (TRD). There is growing evidence on the efficacy for other psychiatric disorders, including posttraumatic stress disorder (PTSD). It is hypothesized that psychotherapy may further potentiate the effects of (es)ketamine in psychiatric disorders.
Repeated oral esketamine was prescribed once or twice weekly in five patients suffering from TRD and comorbid PTSD. We describe the clinical effects of esketamine and report data from psychometric instruments and patients' perspectives.
Esketamine treatment duration ranged from six weeks to a year. In four patients, we observed improvement in depressive symptoms, increased resilience and more receptiveness to psychotherapy. One patient experienced symptom worsening in response to a threatening situation during esketamine treatment, highlighting the need for a safe setting.
(Es)ketamine treatment within a psychotherapeutic framework appears promising in patients with treatment resistant symptoms of depression and PTSD. Controlled trials are warranted to validate these results and to elucidate the optimal treatment methods.
氯胺酮及其S-对映体艾氯胺酮是治疗难治性抑郁症（TRD）的新型药物治疗选择。越来越多的证据表明其对包括创伤后应激障碍（PTSD）在内的其他精神疾病也有效。据推测，心理治疗可能会进一步增强（艾）氯胺酮对精神疾病的疗效。
对5例患有TRD合并PTSD的患者，每周开具一次或两次重复口服艾氯胺酮的处方。我们描述了艾氯胺酮的临床效果，并报告了心理测量工具的数据和患者的观点。
艾氯胺酮治疗持续时间为6周至1年。在4例患者中，我们观察到抑郁症状改善、恢复力增强以及对心理治疗的接受度提高。1例患者在艾氯胺酮治疗期间因面临威胁性情况而症状恶化，这凸显了需要一个安全的环境。
在心理治疗框架内进行（艾）氯胺酮治疗，对于患有难治性抑郁症状和PTSD的患者似乎很有前景。有必要进行对照试验以验证这些结果并阐明最佳治疗方法。
