Ketamine: Promising Path or False Prophecy in the Development of Novel Therapeutics for Mood Disorders?
Ketamine: Promising Path or False Prophecy in the Development of Novel Therapeutics for Mood Disorders?
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DOI：
10.1038/npp.2014.261
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发表时间：
2015-01-01
影响因子：
7.6
通讯作者：
Schatzberg, Alan F.
中科院分区：
文献类型：
--
作者：
Sanacora, Gerard;Schatzberg, Alan F.
大量的“真实的世界”研究表明，与我们现有的抗抑郁药物相关的临床反应有限且起效缓慢，这突出了开发新的治疗策略治疗重度抑郁症和其他情绪障碍的必要性。然而，尽管进行了大量的研究，但在过去的60年里，该领域在开发具有全新作用机制的抗抑郁治疗方面几乎没有取得成功，这使得该领域对任何新的发展都持谨慎和怀疑态度。然而，在过去15年中进行的一系列相对较小的概念验证研究逐渐引起了人们的极大兴趣，这些研究提供了强有力的证据，证明单次给予氯胺酮可以实现独特、快速的持续但时间有限的抗抑郁作用。我们现在对这些发现的真正临床意义和抗抑郁作用的机制有几个问题。在这篇文章中，Sanacora博士和Schatzberg博士分享了他们对这些问题的看法，并讨论了推动该领域向前发展的途径。
Large 'real world' studies demonstrating the limited effectiveness and slow onset of clinical response associated with our existing antidepressant medications has highlighted the need for the development of new therapeutic strategies for major depression and other mood disorders. Yet, despite intense research efforts, the field has had little success in developing antidepressant treatments with fundamentally novel mechanisms of action over the past six decades, leaving the field wary and skeptical about any new developments. However, a series of relatively small proof-of-concept studies conducted over the last 15 years has gradually gained great interest by providing strong evidence that a unique, rapid onset of sustained, but still temporally limited, antidepressant effects can be achieved with a single administration of ketamine. We are now left with several questions regarding the true clinical meaningfulness of the findings and the mechanisms underlying the antidepressant action. In this Circumspectives piece, Dr Sanacora and Dr Schatzberg share their opinions on these issues and discuss paths to move the field forward.