抑郁症的药物治疗进展及艾氯胺酮的应用前景

Research progress of depression and the application of esketamine

抑郁症是一种病因和发病机制不明的精神障碍。抑郁症的发生可能与神经递质分泌减少、神经细胞的凋亡、炎症反应、肠道菌群失调等多种因素有关。目前临床常用的抗抑郁药SSRIs、SNRIs、Na SSA、SARIs类药物虽有一定的效果,但难以缓解抑郁患者所有的症状。近年来研究发现艾氯胺酮主要通过N-甲基-D天冬氨酸受体发挥强大而持久的抗抑郁作用。本文就抑郁症的发病机制、药物治疗研究进展和艾氯胺酮治疗抑郁症的机制、疗效及其应用前景进行综述。目前艾氯胺酮抗抑郁的作用机制未明确,临床尚未普遍应用,但其能迅速缓解抑郁症的症状等优点一定会有广泛的应用前景。

The pathogenesis and etiology of still remain unknown. Current evidence suggests that the occurrence of depression may be related to a reduced secretion of neurotransmitters, neuronal apoptosis, inflammation, intestinal flora and other factors. Although the commonly used antidepressants such as SSRIs, SNRIs, Na SSA, and SARIs produce some therapeutic effects, they fail to relieve the full spectrum of the symptoms of depression. In recent years, esketamine was found to produce a potent and a long-lasting antidepressant effect by acting on the NMDA receptors. Herein the authors review the progress in the study of the pathogenesis and drug therapies of depression, the efficacy of esketamine treatment and the underlying mechanism, and the prospect of esketamine treatment. Currently the mechanism of the antidepressant effect of esketamine remains indeterminate and its clinical application is limited, but its effect in rapidly alleviating the symptoms of depression suggests its bright prospect for clinical applications.