Department of Clinical Neuroscience, Scientific Institute and University Vita Salute San Raffaele.
Mood Disorder Unit, San Raffaele Hospital Branch of San Raffaele Turro site, Milan, Italy.
Int Clin Psychopharmacol. 2024 Mar 1;39(2):117-119. doi: 10.1097/YIC.0000000000000497. Epub 2023 Jul 7.
More than 10 years ago, the discovery of the antidepressant effects of Ketamine opened the opportunity to develop a novel class of antidepressants. Ketamine induces dissociative symptoms as a major side effect. This rapid-acting antidepressant is available as an endovenous racemic compound and as an intranasal S-enantiomer: Esketamine; which is four-fold more potent for the NMDA receptor. Here we present the critical case of a patient who took both molecules experiencing remission just with endovenous Ketamine, whose impact in terms of dissociative symptoms was greater. In this short report, we discuss the differences between the two drugs and the possibility of dissociative features to predict their efficacy.
10 多年前，氯胺酮抗抑郁作用的发现为开发新型抗抑郁药开辟了机会。氯胺酮作为一种主要的副作用会引起分离症状。这种快速作用的抗抑郁药可作为静脉内消旋化合物和鼻内 S-对映体：艾司氯胺酮使用；它对 NMDA 受体的作用要强四倍。在这里，我们介绍了一位患者同时使用这两种分子的关键病例，他仅使用静脉内氯胺酮就缓解了病情，其分离症状的影响更大。在这个简短的报告中，我们讨论了这两种药物的差异以及分离特征预测其疗效的可能性。
