氯胺酮治疗难治性抑郁症的机制与疗效

A review of the mechanism and efficacy of ketamine in the treatment of treatment-resistant depression

大约1/3的抑郁症患者对现有的抗抑郁药无反应而发展为难治性抑郁症(TRD).TRD是一种病程较长的慢性抑郁状态,对当前的治疗方案具有很高的抵抗性,预后较差,给患者家庭及社会带来了沉重负担.现总结当前TRD的治疗方案,对氯胺酮在TRD中使用的证据进行了回顾和分析,重点关注临床给药途径、剂量和疗效持续时间,以及药物的安全性进行讨论,旨在为TRD的临床治疗和氯胺酮的规范使用提供参考依据.

Approximately one-third of patients with depressive develop to treatment-resistant depression(TRD)since they do not respond to existing antidepressants.TRD is a chronic depressive state with a long course of illness,which is highly resistant to current treatment regimens and has poor prognosis,putting a heavy burden on the patient's family and society.This review summarizes the current treatment options for TRD,reviews and analyses the evidence for the use of ketamine in TRD,focusing on clinical routes of administration,dose,and duration of efficacy.Furthermore,ethical factors were added to the safety discussion of ketamine,hoping to provide a reference for the clinical treatment of TRD and the standard use of ketamine.