The intravenous ketamine test predicts subsequent response to an oral dextromethorphan treatment regimen in fibromyalgia patients
The intravenous ketamine test predicts subsequent response to an oral dextromethorphan treatment regimen in fibromyalgia patients
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DOI：
10.1016/j.jpain.2005.12.010
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发表时间：
2006-06-01
期刊：
影响因子：
4
通讯作者：
Mao, Jianren
中科院分区：
文献类型：
--
作者：
Cohen, Steven P.;Verdolin, Michael H.;Mao, Jianren
纤维肌痛（FM）是一种具有挑战性的疼痛综合征，目前尚无可靠的药物治疗方法。最近的临床研究表明，N-甲基-D-天冬氨酸受体可能在这种疾病的发病机制中发挥作用。为了确定静脉内（IV）氯胺酮试验是否可预测对口服N-甲基-D-天冬氨酸受体拮抗剂治疗试验的反应，我们对34例连续FM患者进行了低剂量（0.1 mg/kg）IV氯胺酮输注，随后进行了口服美沙芬（DX）治疗方案。根据之前的指南，IV氯胺酮试验阳性反应的截止值指定为疼痛缓解67%，DX治疗阳性反应为4- 6周随访访视时疼痛减轻50%。氯胺酮和DX的镇痛程度之间的相关程度非常显著（Pearson相关系数，0.66; P
Fibromyalgia (FM) is a challenging pain syndrome for which no reliable pharmacologic treatment exists. Recent clinical studies suggest that N-methyl-D-aspartate receptors might play a role in the pathogenesis of this disorder. To determine whether an intravenous (IV) ketamine test predicts the response to a therapeutic trial with an oral N-methyl-D-aspartate receptor antagonist, we performed a low-dose (0.1 mg/kg) IV ketamine infusion on 34 consecutive patients with FM, which was subsequently followed by an oral dextromethorphan (DX) treatment regimen. As per previous guidelines, the cutoff value for a positive response to the IV ketamine test was designated to be 67% pain relief, and a positive response to DX treatment was 50% pain reduction at 4- to 6-week follow-up visits. The degree of correlation between pain relief with ketamine and DX was highly significant (Pearson correlation coefficient, 0.66; P