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抑郁症、创伤后应激障碍、自杀意念与氯胺酮:一例报告

Depression, post-traumatic stress disorder, suicidal ideation and ketamine: a case report.

作者信息

Asad S, Latifzai K, Eliopoulos V T, Oakley D S, Pates J, Towers G

机构信息

Baptist Medical Center, Jacksonville, FL, USA.

Rocky Mountain Regenerative Medicine, Boulder, CO, USA.

出版信息

J Med Case Rep. 2024 Dec 24;18(1):638. doi: 10.1186/s13256-024-04972-8.

Abstract

BACKGROUND

Ketamine treatment presents a novel approach for addressing refractory conditions, such as major depressive disorder, suicidal ideation, and posttraumatic stress disorder, which often co-occur and pose significant challenges for clinicians. This study explores the clinical and electrophysiological outcomes of ketamine treatment in two cases, shedding light on its potential efficacy and mechanisms of action.

CASE PRESENTATION

The first case involves a 56-year-old Caucasian male with chronic posttraumatic stress disorder and suicidal ideation, and the second case involves a 52-year-old Caucasian female with treatment-resistant major depressive disorder. Both patients opted for ketamine treatment after years of unsuccessful interventions. The male patient received nine ketamine infusions over 18 months, while the female patient received five infusions over one month. Symptom improvement was accompanied by distinct electrophysiological changes, as observed through electroencephalogram and evoked electroencephalogram responses. These changes persisted for several months post-treatment, offering hope for individuals grappling with challenging chronic conditions.

CONCLUSION

Ketamine infusions resulted in significant and sustained symptomatic improvement in both cases, accompanied by distinct electrophysiological changes indicative of altered brain function. These findings highlight the potential of ketamine as an alternative treatment for refractory conditions, such as major depressive disorder and posttraumatic stress disorder, offering relief and functional recovery for certain patients. Further research is warranted to elucidate the underlying mechanisms and optimize treatment protocols.

摘要

背景

氯胺酮治疗为解决难治性疾病提供了一种新方法,如重度抑郁症、自杀意念和创伤后应激障碍,这些疾病常同时出现,给临床医生带来重大挑战。本研究探讨了两例氯胺酮治疗的临床和电生理结果,以揭示其潜在疗效和作用机制。

病例介绍

第一例患者为一名56岁的白人男性,患有慢性创伤后应激障碍和自杀意念;第二例患者为一名52岁的白人女性,患有难治性重度抑郁症。经过多年干预均未成功后,两名患者均选择了氯胺酮治疗。男性患者在18个月内接受了9次氯胺酮输注,而女性患者在1个月内接受了5次输注。通过脑电图和诱发脑电图反应观察到,症状改善伴随着明显的电生理变化。这些变化在治疗后持续了几个月,为患有具有挑战性的慢性病的个体带来了希望。

结论

氯胺酮输注在两例患者中均导致了显著且持续的症状改善,同时伴有明显的电生理变化,表明脑功能发生了改变。这些发现突出了氯胺酮作为重度抑郁症和创伤后应激障碍等难治性疾病替代治疗方法的潜力,为某些患者带来缓解和功能恢复。有必要进行进一步研究以阐明潜在机制并优化治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82e1/11669204/beeeffecd2d5/13256_2024_4972_Fig1_HTML.jpg

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