Department of Anesthesiology & Pain Medicine and Department of Physiology, University of Toronto, Toronto, Canada; Perioperative Brain Health Centre, Sunnybrook Health Sciences Centre, Toronto, Canada.
Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry and Department of Pharmacology, University of Toronto, Toronto, Canada.
Anesthesiology. 2024 Aug 1;141(2):222-237. doi: 10.1097/ALN.0000000000005037.
During the last 100 years, the role of anesthesiologists in psychiatry has focused primarily on facilitating electroconvulsive therapy and mitigating postoperative delirium and other perioperative neurocognitive disorders. The discovery of the rapid and sustained antidepressant properties of ketamine, and early results suggesting that other general anesthetic drugs (including nitrous oxide, propofol, and isoflurane) have antidepressant properties, has positioned anesthesiologists at a new frontier in the treatment of neuropsychiatric disorders. Moreover, shared interest in understanding the biologic underpinnings of anesthetic drugs as psychotropic agents is eroding traditional academic boundaries between anesthesiology and psychiatry. This article presents a brief overview of anesthetic drugs as novel antidepressants and identifies promising future candidates for the treatment of depression. The authors issue a call to action and outline strategies to foster collaborations between anesthesiologists and psychiatrists as they work toward the common goals of repurposing anesthetic drugs as antidepressants and addressing mood disorders in surgical patients.
在过去的 100 年中，麻醉医师在精神病学中的作用主要集中在促进电惊厥疗法和减轻术后谵妄和其他围手术期神经认知障碍上。氯胺酮具有快速和持续的抗抑郁作用的发现，以及早期结果表明其他全身麻醉药物（包括一氧化二氮、异丙酚和异氟烷）具有抗抑郁作用，使麻醉医师在神经精神疾病治疗的新前沿处于有利地位。此外，人们对理解麻醉药物作为精神药物的生物学基础的共同兴趣正在侵蚀麻醉学和精神病学之间传统的学术界限。本文简要概述了作为新型抗抑郁药的麻醉药物，并确定了有前途的未来候选药物，用于治疗抑郁症。作者呼吁采取行动，并概述了在麻醉医师和精神科医生之间建立合作关系的策略，以实现将麻醉药物重新用作抗抑郁药和解决手术患者情绪障碍的共同目标。
