Course of Improvement in Depressive Symptoms to a Single Intravenous Infusion of Ketamine vs Add-on Riluzole: Results from a 4-Week, Double-Blind, Placebo-Controlled Study
Course of Improvement in Depressive Symptoms to a Single Intravenous Infusion of Ketamine vs Add-on Riluzole: Results from a 4-Week, Double-Blind, Placebo-Controlled Study
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DOI：
10.1038/npp.2011.338
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发表时间：
2012-05-01
影响因子：
7.6
通讯作者：
Zarate, Carlos A., Jr.
中科院分区：
文献类型：
--
作者：
Ibrahim, Lobna;DiazGranados, Nancy;Zarate, Carlos A., Jr.
N-甲基-D-天冬氨酸拮抗剂氯胺酮对难治性重度抑郁症 (TRD) 患者具有快速抗抑郁作用；据报道，这些作用在某些患者中可持续 1 周。然而，在受控条件下，这种长期抗抑郁作用的程度和持续时间尚未得到很好的表征。利鲁唑是一种谷氨酸能调节剂，具有抗抑郁和增强突触可塑性的作用，可以用来促进氯胺酮的抗抑郁作用。本研究旨在确定 4 周内单次氯胺酮输注抗抑郁药改善的程度和时间过程，比较输注后添加利鲁唑与安慰剂。 42 名患有 TRD 且蒙哥马利-阿斯伯格抑郁量表 (MADRS) 评分≥ 22 的受试者 (18-65) 接受了单次静脉输注氯胺酮 (0.5 mg/kg)。输注后 4 至 6 小时，受试者被随机接受利鲁唑（100-200 毫克/天；n = 21）或安慰剂（n = 21）双盲治疗，为期 4 周。每天对抑郁症状进行评级。显着改善（P
The N-methyl-D-aspartate antagonist ketamine has rapid antidepressant effects in patients with treatment-resistant major depression (TRD); these effects have been reported to last for 1 week in some patients. However, the extent and duration of this antidepressant effect over longer periods has not been well characterized under controlled conditions. Riluzole, a glutamatergic modulator with antidepressant and synaptic plasticity-enhancing effects, could conceivably be used to promote the antidepressant effects of ketamine. This study sought to determine the extent and time course of antidepressant improvement to a single-ketamine infusion over 4 weeks, comparing the addition of riluzole vs placebo after the infusion. Forty-two subjects (18-65) with TRD and a Montgomery-Asberg Depression Rating Scale (MADRS) score of >= 22 received a single intravenous infusion of ketamine (0.5 mg/kg). Four to six hours post-infusion, subjects were randomized to double-blind treatment with either riluzole (100-200 mg/day; n = 21) or placebo (n = 21) for 4 weeks. Depressive symptoms were rated daily. A significant improvement (P