Yang Kevin H, Kepner Wayne, Cleland Charles M, Palamar Joseph J
University of California San Diego School of Medicine, Department of Psychiatry, 9500 Gilman Drive, San Diego, CA 92093, USA.
University of California San Diego School of Medicine, Department of Medicine, 9500 Gilman Drive, San Diego, CA 92093, USA.
J Affect Disord. 2025 Mar 15;373:345-352. doi: 10.1016/j.jad.2024.12.108. Epub 2024 Dec 31.
Ketamine's potential for treating depression has drawn increased clinical interest in recent years. However, despite growing therapeutic use, recreational use among individuals with depression remain underexplored.
We analyzed data from the 2015-2022 National Survey on Drug Use and Health focusing on adults in the US. Trends in past-year ketamine use, overall and by depression status, were estimated separately for 2015-2019 and 2021-2022 due to methodological changes in the survey. We also delineated correlates of ketamine use in each period, focusing on depression, sociodemographic characteristics, and other past-year drug use.
Overall ketamine use prevalence increased from 2015 to 2019 (from 0.11 % to 0.20 %, an 81.8 % increase, p < 0.01) and from 2021 to 2022 (from 0.20 % to 0.28 %, a 40.0 % increase, p < 0.05). From 2015 to 2019, use increased among adults with and without depression (by 139.3 % [p < 0.05] and 66.7 % [p < 0.05], respectively), while from 2021 to 2022, an increase occurred only among those without depression (by 38.9 %, p < 0.05). Multivariable models revealed that depression was associated with increased odds of ketamine use in 2015-2019 (aOR = 1.80, 95 % CI: 1.12-2.89) but not in later years. New sociodemographic correlates emerged in 2021-2022, including adults aged 26-34 and those with a college degree being at higher odds for use. Various drugs (especially ecstasy/MDMA and gamma-hydroxybutyrate) were consistently associated with higher odds of use.
We identified differential patterns and correlates of ketamine use over time. Shifts may be related to the evolving ketamine landscape and/or changing survey methodology. Monitoring of use patterns is crucial to inform prevention and harm reduction strategies.
近年来,氯胺酮治疗抑郁症的潜力引起了越来越多的临床关注。然而,尽管其治疗用途不断增加,但抑郁症患者中的娱乐性使用情况仍未得到充分研究。
我们分析了2015 - 2022年美国全国药物使用和健康调查的数据,重点关注美国成年人。由于调查方法的变化,分别估计了2015 - 2019年和2021 - 2022年过去一年氯胺酮使用的总体趋势以及按抑郁状况划分的趋势。我们还描述了每个时期氯胺酮使用的相关因素,重点关注抑郁症、社会人口学特征以及其他过去一年的药物使用情况。
总体氯胺酮使用患病率在2015年至2019年期间有所上升(从0.11%升至0.20%,增长81.8%,p < 0.01),在2021年至2022年期间也有所上升(从0.20%升至0.28%,增长40.0%,p < 0.05)。2015年至2019年期间,有抑郁症和无抑郁症的成年人使用量均有所增加(分别增加139.3% [p < 0.05]和66.7% [p < 0.05]),而2021年至2022年期间,仅无抑郁症的成年人使用量有所增加(增加38.9%,p < 0.05)。多变量模型显示,抑郁症在2015 - 2019年与氯胺酮使用几率增加相关(调整后比值比[aOR] = 1.80,95%置信区间[CI]:1.12 - 2.89),但在随后几年并非如此。2021 - 2022年出现了新的社会人口学相关因素,包括26 - 34岁的成年人以及拥有大学学位的人使用几率更高。各种药物(尤其是摇头丸/MDMA和γ-羟基丁酸)一直与更高的使用几率相关。
我们确定了氯胺酮使用随时间变化的不同模式和相关因素。这些变化可能与氯胺酮情况的演变和/或调查方法的改变有关。监测使用模式对于制定预防和减少危害策略至关重要。