The promise of ketamine for treatment-resistant depression: current evidence and future directions
The promise of ketamine for treatment-resistant depression: current evidence and future directions
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DOI：
10.1111/nyas.12646
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发表时间：
2015-01-01
期刊：
影响因子：
--
通讯作者：
Iosifescu, Dan V.
中科院分区：
文献类型：
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作者：
DeWilde, Kaitlin E.;Levitch, Cara F.;Iosifescu, Dan V.
重性抑郁症（MDD）是世界范围内最严重的致残性疾病之一，并正在成为一个重大的公共卫生威胁。目前MDD的治疗主要由单胺靶向药物组成，疗效有限。然而，谷氨酸神经递质系统最近成为焦点，作为一种有前途的替代新的抗抑郁药治疗。我们回顾了谷氨酸NMDA受体拮抗剂氯胺酮的当前数据，氯胺酮在临床试验中已被证明是MDD的快速抗抑郁药。我们还研究了氯胺酮对精神病理学维度的疗效，包括快感缺乏，认知和自杀倾向，与NIMH研究领域标准倡议一致。本文综述的氯胺酮的其他方面包括安全性和有效性，不同的给药方法，以及在医疗环境之外滥用氯胺酮的风险。最后，我们总结了目前正在测试的新的抗抑郁药氯胺酮以外的药物的讨论。
Major depressive disorder (MDD) is one of the most disabling diseases worldwide and is becoming a significant public health threat. Current treatments for MDD primarily consist of monoamine-targeting agents and have limited efficacy. However, the glutamate neurotransmitter system has recently come into focus as a promising alternative for novel antidepressant treatments. We review the current data on the glutamate NMDA receptor antagonist ketamine, which has been shown in clinical trials to act as a rapid antidepressant in MDD. We also examine ketamine efficacy on dimensions of psychopathology, including anhedonia, cognition, and suicidality, consistent with the NIMH Research Domain Criteria initiative. Other aspects of ketamine reviewed in this paper include safety and efficacy, different administration methods, and the risks of misuse of ketamine outside of medical settings. Finally, we conclude with a discussion of glutamatergic agents other than ketamine currently being tested as novel antidepressants.