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氯胺酮在儿童和青少年精神病学中的应用:治疗抵抗性抑郁症的新数据、来自成人的见解以及未来方向。

Ketamine Use in Child and Adolescent Psychiatry: Emerging Data in Treatment-Resistant Depression, Insights from Adults, and Future Directions.

机构信息

Department of Psychiatry, Adolescent Partial Hospitalization Program, Trinity Health Ann Arbor Hospital, Ann Arbor, MI, USA.

Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA.

出版信息

Curr Psychiatry Rep. 2023 Aug;25(8):337-344. doi: 10.1007/s11920-023-01432-w. Epub 2023 Jun 30.

Abstract

PURPOSE OF REVIEW

The following review will explore ketamine's antidepressant and antisuicidal properties in adults, review of what is known about ketamine's safety in children, and summarize the limited information we have on ketamine's role in treating depression and suicidal ideation in adolescents with depression. Future directions for ketamine's role in child psychiatry based on animal and adult studies will also be explored.

RECENT FINDINGS

Over the past 20 years, ketamine has emerged as a novel treatment for depression and suicidal ideation in adults. In recent years, these studies have been extended to adolescents. In 2021, the first placebo-controlled trial examining ketamine's antidepressant potential in adolescents was performed, demonstrating superior efficacy over midazolam. Initial studies suggest that ketamine functions as a rapidly acting antidepressant in adolescents. Case reports suggest that ketamine may also reduce suicidal ideation in this population. However, existing studies are small, and more research is needed to solidify these findings and inform clinical practice.

摘要

目的综述

本篇综述将探讨氯胺酮在成人中的抗抑郁和抗自杀特性,回顾关于儿童氯胺酮安全性的已知信息,并总结关于氯胺酮在治疗青少年抑郁症和自杀意念方面作用的有限信息。还将探讨基于动物和成人研究的氯胺酮在儿童精神病学中的作用的未来方向。

最近的发现

在过去的 20 年中,氯胺酮已成为治疗成人抑郁症和自杀意念的一种新方法。近年来,这些研究已扩展到青少年群体。2021 年,进行了第一项评估氯胺酮在青少年中抗抑郁潜力的安慰剂对照试验,结果表明其疗效优于咪达唑仑。初步研究表明,氯胺酮在青少年中具有快速起效的抗抑郁作用。病例报告表明,氯胺酮也可能降低该人群的自杀意念。然而,现有的研究规模较小,需要更多的研究来证实这些发现并为临床实践提供信息。

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