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单剂量氯胺酮治疗重度抑郁症的疗效及副作用评估。

An evaluation of the efficacy and side effects of a single dose of ketamine in major depressive disorder.

作者信息

Uyar Betül, Güneş Mehmet

机构信息

Dicle University Medical Faculty, Department of Psychiatry, 21280 Diyarbakır, Türkiye.

出版信息

Postgrad Med J. 2025 Jul 22;101(1198):716-722. doi: 10.1093/postmj/qgae142.

Abstract

AIM

This study aims to provide a comprehensive overview of the antidepressant and antisuicidal efficacy of ketamine in patients with unipolar depression, with a focus on the clinical evidence and safety profile.

MATERIAL-METHOD: In our study, the data of 120 major depressive disorder patients who received single-dose ketamine infusion therapy were evaluated retrospectively, with Montgomery-Asberg Depression Rating Scale (MADRS) applied by the clinician before treatment and at the 4th and 24th hours after treatment and side effects at 4 and 24 hours after treatment.

RESULTS

There was a statistically significant difference between MADRS and MADRS-Suicide scores of all participants before the ketamine infusion (0th hour) and at the 4th and 24th hours after the ketamine infusion. Also, male and female, RAT(+) and RAT(-), and SA(+) and SA(-) participants have statistically significant differences on all three times for both MADRS and MADRS-S scores.

CONCLUSION

The findings of this study are in line with those from previous research that demonstrated the rapid and robust antidepressant effects of ketamine, even in individuals with severe, treatment-resistant depression. Moreover, the observed reduction in suicidal ideation is particularly noteworthy, given the critical need for interventions that can provide rapid relief in acute suicidal crises. Key message What is already known on this topic - Ketamine is known for its rapid antidepressant and antisuicidal effects in treatment-resistant major depressive disorder, demonstrating significant symptom relief within hours of administration. What this study adds - This study provides additional evidence supporting ketamine's rapid efficacy in reducing depressive symptoms and suicidal ideation, highlighting statistically significant improvements observed at 4 and 24 hours post-treatment. How this study might affect research, practice, or policy - The findings may encourage broader clinical adoption of ketamine for acute depressive episodes and suicidality, emphasizing the need for controlled medical settings to manage potential side effects, and could influence future research on optimizing dosing protocols and long-term safety.

摘要

目的

本研究旨在全面概述氯胺酮治疗单相抑郁症患者的抗抑郁和抗自杀疗效,重点关注临床证据和安全性。

材料与方法

在我们的研究中,回顾性评估了120例接受单剂量氯胺酮输注治疗的重度抑郁症患者的数据,由临床医生在治疗前、治疗后第4小时和第24小时应用蒙哥马利-阿斯伯格抑郁评定量表(MADRS),并记录治疗后第4小时和第24小时的副作用。

结果

所有参与者在氯胺酮输注前(第0小时)以及输注后第4小时和第24小时的MADRS和MADRS-自杀评分之间存在统计学显著差异。此外,男性和女性、快速动眼睡眠期(RAT)阳性和阴性、自杀行为(SA)阳性和阴性参与者在MADRS和MADRS-S评分的所有三个时间点上均存在统计学显著差异。

结论

本研究结果与先前研究一致,先前研究表明氯胺酮具有快速且显著的抗抑郁作用,即使在重度、难治性抑郁症患者中也是如此。此外,鉴于迫切需要能够在急性自杀危机中提供快速缓解的干预措施,观察到的自杀意念减少尤其值得注意。关键信息 关于该主题已有的知识 - 氯胺酮以其在难治性重度抑郁症中的快速抗抑郁和抗自杀作用而闻名,在给药后数小时内即可显著缓解症状。本研究的补充内容 - 本研究提供了额外证据,支持氯胺酮在减轻抑郁症状和自杀意念方面的快速疗效,突出了治疗后第4小时和第24小时观察到的统计学显著改善。本研究可能对研究、实践或政策产生的影响 - 研究结果可能会鼓励更广泛地在临床中采用氯胺酮治疗急性抑郁发作和自杀行为,强调需要在可控的医疗环境中管理潜在副作用,并且可能会影响未来关于优化给药方案和长期安全性的研究。

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