Skala Katrin, Doganay Kamer, Eder Harald, Mairhofer Dunja, Neubacher Katrin, Plener Paul L
Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria.
Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.
Front Psychiatry. 2023 Jun 2;14:1118737. doi: 10.3389/fpsyt.2023.1118737. eCollection 2023.
Depression is among the most common mental health disorders worldwide and treatment resistant depression (TRD) represents a major challenge for both patients and clinicians. In recent years ketamine has received attention as an antidepressant agent, demonstrating promising results in TRD in adults. To date, few attempts have been made in treating adolescent TRD with ketamine and none have used intranasal application. This paper discusses a case of a 17-year-old female adolescent suffering from TRD who underwent treatment with intranasal esketamine application (Spravato 28 mg). As symptoms showed clinically insignificant improvement despite modest gains in objective assessments (GAF, CGI, MADRS), treatment was prematurely discontinued. However, the treatment was tolerable and side effects were scarce and mild. Although this case report does not demonstrate clinical effectiveness, ketamine may nonetheless be a promising substance in treating TRD in other adolescents. Questions regarding the safety of ketamine use in the rapidly developing brains of adolescents still remain unanswered. To further explore the potential benefits of this treatment method a short term RCTs for adolescents with TRD is recommended.
抑郁症是全球最常见的精神健康障碍之一，难治性抑郁症（TRD）对患者和临床医生来说都是一项重大挑战。近年来，氯胺酮作为一种抗抑郁药受到关注，在成人TRD治疗中显示出有前景的结果。迄今为止，很少有人尝试用氯胺酮治疗青少年TRD，且没有人使用鼻内给药。本文讨论了一例17岁患有TRD的女性青少年，她接受了鼻内使用艾氯胺酮（Spravato 28毫克）的治疗。尽管客观评估（GAF、CGI、MADRS）有适度改善，但症状在临床上改善不显著，治疗提前终止。然而，治疗是可耐受的，副作用很少且轻微。虽然本病例报告未证明临床有效性，但氯胺酮在治疗其他青少年TRD方面仍可能是一种有前景的物质。关于在青少年快速发育的大脑中使用氯胺酮的安全性问题仍未得到解答。为进一步探索这种治疗方法的潜在益处，建议对患有TRD的青少年进行短期随机对照试验。
