Pardossi Simone, Fagiolini Andrea, Scheggi Simona, Cuomo Alessandro
Department of Molecular Medicine, University of Siena School of Medicine, 53100 Siena, Italy.
Children (Basel). 2024 Jun 29;11(7):801. doi: 10.3390/children11070801.
Treating depression in adolescents is a significant challenge, and major depressive disorder (MDD) with suicidal ideation and treatment-resistant depression (TRD) are common and potentially devastating to optimal psychological and physical development in this age group. Suicide is among the leading causes of youth mortality, and TRD occurs in up to 40% of adolescents with MDD. TRD involves severe, persistent symptoms that are hard to treat, significantly reducing functioning and quality of life. We conducted a literature search focusing on key terms related to ketamine and esketamine for MDD with suicidal ideation and TRD in adolescents, aiming to review the potential utility of these molecules in adolescents for these conditions. Ketamine has shown efficacy in reducing depressive symptoms in adolescents with TRD. Esketamine has shown efficacy in reducing depressive symptoms and treating suicidal ideation in adolescents. Both ketamine and esketamine have demonstrated favorable safety and tolerability profiles. Using these drugs for serious conditions like adolescent MDD with suicidal thoughts and TRD can effectively treat symptoms, reduce self-harm and suicide risks, and provide a window for longer-term therapeutic interventions. The prompt and effective treatment of TRD could improve adolescents' quality of life. However, more research is needed to optimize treatment protocols and evaluate long-term effects.
治疗青少年抑郁症是一项重大挑战，伴有自杀意念的重度抑郁症（MDD）和难治性抑郁症（TRD）在该年龄组中很常见，并且可能对最佳心理和身体发育造成毁灭性影响。自杀是青少年死亡的主要原因之一，TRD在高达40%的患有MDD的青少年中出现。TRD涉及严重、持续且难以治疗的症状，会显著降低功能和生活质量。我们进行了一项文献检索，重点关注与氯胺酮和艾司氯胺酮相关的关键术语，用于治疗青少年伴有自杀意念和TRD的MDD，旨在综述这些分子在青少年中针对这些病症的潜在效用。氯胺酮已显示出对患有TRD的青少年有减轻抑郁症状的疗效。艾司氯胺酮已显示出对青少年有减轻抑郁症状和治疗自杀意念的疗效。氯胺酮和艾司氯胺酮均已证明具有良好的安全性和耐受性。将这些药物用于治疗像伴有自杀念头和TRD的青少年MDD这样的严重病症，可以有效治疗症状、降低自我伤害和自杀风险，并为长期治疗干预提供契机。及时有效地治疗TRD可以改善青少年的生活质量。然而，需要更多研究来优化治疗方案并评估长期效果。
