Effects of ketamine in normal and schizophrenic volunteers
Effects of ketamine in normal and schizophrenic volunteers
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DOI：
10.1016/s0893-133x(01)00243-3
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发表时间：
2001-10-01
影响因子：
7.6
通讯作者：
Tamminga, CA
中科院分区：
文献类型：
--
作者：
Lahti, AC;Weiler, MA;Tamminga, CA
本研究评估氯胺酮对健康和精神分裂症志愿者（SV）的影响，以确定该药物在精神病模型中的详细行为效应。我们比较了氯胺酮对正常和SV的影响，以确定其反应的可比性以及正常受试者可在实验中用作模型的程度。18名正常志愿者（NV）和17名SV参加了氯胺酮访谈。一些（n = 7个NV; n = 9 SV）接受4次0.1-0.5 mg/kg氯胺酮和安慰剂治疗;其他（n = 11 NV; n = 8 SV）接受2次1剂氯胺酮（0.3 mg/kg）和安慰剂治疗。经验丰富的临床研究人员使用BPRS评估精神状态随时间的任何变化，并及时记录具体情况。在两个志愿者组中，氯胺酮诱导了剂量相关的精神病症状的短暂（< 30分钟）增加。简明精神病评定量表（BPRS）精神病子量表（p = .0001）和BPRS戒断子量表（p = .0001）的NV评分均增加，而SV仅在阳性症状中增加（p = .0001）。70%的患者报告增加（即，以前经历过的阳性症状的恶化）。正常组和精神分裂症组仅在BPRS戒断评分上存在差异。氯胺酮诱导的阳性症状变化幅度相似，尽管精神病基线不同，但两个人群随时间的剂量反应曲线可重叠。SV中氯胺酮诱导的症状与其自身阳性症状之间的相似性表明，氯胺酮为人类志愿者提供了一种独特的精神病模型。这些数据表明，精神分裂症的苯环利定（PCP）模型可能是一个更有效的人类精神病/精神分裂症药物模型比安非他明模型，具有更广泛的精神病症状。这项研究表明，NVs可以用于许多信息丰富的实验精神病研究，涉及氯胺酮的采访。
This study evaluates the effects of ketamine on healthy and schizophrenic volunteers (SVs) in an effort to define the detailed behavioral effects of the drug in a psychosis model. We compared the effects of ketamine on normal and SVs to establish the comparability of their responses and the extent to which normal subjects might be used experimentally as a model. Eighteen normal volunteers (NVs) and 17 SVs participated in ketamine interviews. Some (n = 7 NVs; n = 9 SVs) had four sessions with a 0.1-0.5 mg/kg of ketamine and a placebo; others (n = 11 NVs; n = 8 SVs) had two sessions with one dose of ketamine (0.3 mg/kg) and a placebo. Experienced research clinicians used the BPRS to assess any change in mental status over time and documented the specifics in a timely way. In both volunteer groups, ketamine induced a dose-related, short (< 30 min) increase in psychotic symptoms. The scores of NVs increased on both the Brief Psychiatric Rating Scale (BPRS) psychosis subscale (p = .0001) and the BPRS withdrawal subscale (p = .0001), whereas SVs experienced an increase only in positive symptoms (p = .0001). Seventy percent of the patients reported an increase (i.e., exacerbation) of previously experienced positive symptoms. Normal and schizophrenic groups differed only on the BPRS withdrawal score. The magnitude of ketamine-induced changes in positive symptoms was similar, although the psychosis baseline differed, and the dose-response profiles over time were superimposable across the two populations. The similarity between ketamine-induced symptoms in SVs and their own positive symptoms suggests that ketamine provides a unique model of psychosis in human volunteers. The data suggest that the phencyclidine (PCP) model of schizophrenia maybe a more valid human psychosis/schizophrenia drug model than the amphetamine model, with a broader range of psychotic symptoms. This study indicates that NVs could be used for many informative experimental psychosis studies involving ketamine interviews.