Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de janeiro, Brazil.
Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de janeiro, Brazil.
J Psychoactive Drugs. 2024 Sep-Oct;56(4):496-512. doi: 10.1080/02791072.2023.2248989. Epub 2023 Aug 28.
Depression is one of the most prevalent mental health disorders globally, causing severe emotional suffering, reducing life expectancy and increasing the risk of suicide. Recently, the use of dissociative psychedelic substances such as ketamine and esketamine for depressive disorders has expanded treatment options. We sought to analyze, through a systematic review, the existing protocols for the treatment of depression with ketamine and esketamine. The search adopted PRISMA criteria and was performed using PubMed and Web of Science databases. Procedures in each study were compared, focusing on the sample recruited, therapeutic approaches, including the clinical team and professionals engaged in treatment, medical procedures, description of the setting (including music) and factors such as specific medication (ketamine or esketamine), route of administration and dosage employed. Results indicated the predominance of a medical approach, with a limited number of studies on ketamine assisted psychotherapy (KAP) and other modalities of psychedelic assisted therapy. Additionally, there is limited information on psychosocial elements such as preparation, psychological support during session and integration of experience. Altogether these findings suggest that treatment of depression with ketamine or esketamine diverges in relation to the practices employed with psychedelic substances. This is discussed considering future research directions in the field.
抑郁症是全球最普遍的心理健康障碍之一，它会导致严重的情绪痛苦，降低预期寿命，并增加自杀风险。最近，使用分离性迷幻物质（如氯胺酮和 Esketamine）治疗抑郁症已经扩展了治疗选择。我们试图通过系统评价分析现有的氯胺酮和 Esketamine 治疗抑郁症的方案。该搜索采用了 PRISMA 标准，并使用了 PubMed 和 Web of Science 数据库。比较了每项研究中的程序，重点关注招募的样本、治疗方法，包括参与治疗的临床团队和专业人员、医疗程序、设置（包括音乐）的描述以及特定药物（氯胺酮或 Esketamine）、给药途径和剂量等因素。结果表明，以医学方法为主导，关于氯胺酮辅助心理治疗（KAP）和其他迷幻辅助治疗模式的研究较少。此外，关于心理社会因素的信息有限，如准备、治疗期间的心理支持以及经验的整合。总之，这些发现表明，使用氯胺酮或 Esketamine 治疗抑郁症与使用迷幻物质的实践存在差异。考虑到该领域未来的研究方向，对这一现象进行了讨论。
