Rapid and longer-term antidepressant effects of repeated ketamine infusions in treatment-resistant major depression.
Rapid and longer-term antidepressant effects of repeated ketamine infusions in treatment-resistant major depression.
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DOI：
10.1016/j.biopsych.2012.06.022
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发表时间：
2013-08-15
影响因子：
10.6
通讯作者：
Iosifescu, Dan V.
中科院分区：
文献类型：
--
作者：
Murrough, James W.;Perez, Andrew M.;Pillemer, Sarah;Stern, Jessica;Parides, Michael K.;aan het Rot, Marije;Collins, Katherine A.;Mathew, Sanjay J.;Charney, Dennis S.;Iosifescu, Dan V.
关键词：
据报告，氯胺酮具有快速抗抑郁作用，但对单次输注后氯胺酮作用的时程了解有限。之前的一份报告包括10名患有难治性抑郁症（TRD）的参与者，发现6次氯胺酮输注导致持续的抗抑郁作用。在本报告中，我们在较大样本中检查了重复氯胺酮输注的抗抑郁作用的模式和持久性，包括原始样本。TRD受试者（n=24）接受了抗抑郁药物洗脱，随后接受了一系列氯胺酮（0.5 mg/kg）静脉（IV）输注，最多6次，每周开放标签给药3次，持续12天。从末次输注开始，对符合缓解标准的参与者进行长达83天的复发监测。研究结束时总有效率为70.8%。在首次氯胺酮输注后2小时，蒙哥马利-艾斯伯格抑郁评定量表（MADRS）评分平均值大幅下降（18.9±6.6，p<0.001），并且这种下降在输注期间基本持续。研究结束时的反应强烈预测了4小时的反应（94%灵敏度，71%特异性）。在应答者中，末次氯胺酮输注后至复发的中位时间为18天。氯胺酮与TRD的快速抗抑郁作用相关，可预测持续作用。未来的对照研究将需要确定策略，以维持从氯胺酮疗程中获益的患者的抗抑郁反应。
Ketamine is reported to have rapid antidepressant effects, however there is limited understanding of the time-course of ketamine effects beyond a single infusion. A previous report including 10 participants with treatment-resistant major depression (TRD) found that six ketamine infusions resulted in a sustained antidepressant effect. In the current report, we examined the pattern and durability of antidepressant effects of repeated ketamine infusions in larger sample, inclusive of the original. Participants with TRD (n=24) underwent a washout of antidepressant medication followed by a series of up to six intravenous (IV) infusions of ketamine (0.5 mg/kg) administered open-label three times weekly over a 12-day period. Participants meeting response criteria were monitored for relapse for up to 83 days from the last infusion. The overall response rate at study end was 70.8%. There was a large mean decrease in Montgomery–Asberg Depression Rating Scale (MADRS) score at two hours following the first ketamine infusion (18.9±6.6, p<0.001) and this decrease was largely sustained for the duration of the infusion period. Response at study end was strongly predicted by response at four hours (94% sensitive, 71% specific). Among responders, median time to relapse following the last ketamine infusion was 18 days. Ketamine was associated with a rapid antidepressant effect in TRD that was predictive of a sustained effect. Future controlled studies will be required to identify strategies to maintain an antidepressant response among patients who benefit from a course of ketamine.
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影响因子：
64.8
作者：
Autry, Anita E.;Adachi, Megunai;Nosyreva, Elena;Na, Elisa S.;Los, Maarten F.;Cheng, Peng-fei;Kavalali, Ege T.;Monteggia, Lisa M.
通讯作者：
Monteggia, Lisa M.
影响因子：
6.7
作者：
通讯作者：
--
DOI：
10.1126/science.1190287
发表时间：
2010-08-20
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Li N;Lee B;Liu RJ;Banasr M;Dwyer JM;Iwata M;Li XY;Aghajanian G;Duman RS
通讯作者：
Duman RS
影响因子：
10.6
作者：
aan het Rot, Marije;Collins, Katherine A.;Mathew, Sanjay J.
通讯作者：
Mathew, Sanjay J.
DOI：
10.4088/jcp.09m05327blu
发表时间：
2010-12
期刊：
The Journal of clinical psychiatry
影响因子：
--
作者：
DiazGranados N;Ibrahim LA;Brutsche NE;Ameli R;Henter ID;Luckenbaugh DA;Machado-Vieira R;Zarate CA Jr
通讯作者：
Zarate CA Jr