Therapeutic Protocols Using Ketamine and Esketamine for Depressive Disorders: A Systematic Review.

IF 2.1 4区 医学 Q2 PSYCHOLOGY, CLINICAL Journal of psychoactive drugs Pub Date : 2024-09-01 Epub Date: 2023-08-28 DOI:10.1080/02791072.2023.2248989
Julia M K Freind, Fernando R Beserra, Bruno S Menezes, Daniel C Mograbi
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Abstract

Depression is one of the most prevalent mental health disorders globally, causing severe emotional suffering, reducing life expectancy and increasing the risk of suicide. Recently, the use of dissociative psychedelic substances such as ketamine and esketamine for depressive disorders has expanded treatment options. We sought to analyze, through a systematic review, the existing protocols for the treatment of depression with ketamine and esketamine. The search adopted PRISMA criteria and was performed using PubMed and Web of Science databases. Procedures in each study were compared, focusing on the sample recruited, therapeutic approaches, including the clinical team and professionals engaged in treatment, medical procedures, description of the setting (including music) and factors such as specific medication (ketamine or esketamine), route of administration and dosage employed. Results indicated the predominance of a medical approach, with a limited number of studies on ketamine assisted psychotherapy (KAP) and other modalities of psychedelic assisted therapy. Additionally, there is limited information on psychosocial elements such as preparation, psychological support during session and integration of experience. Altogether these findings suggest that treatment of depression with ketamine or esketamine diverges in relation to the practices employed with psychedelic substances. This is discussed considering future research directions in the field.

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使用氯胺酮和 Esketamine 治疗抑郁症的方案:系统性综述。
抑郁症是全球最普遍的精神疾病之一,会造成严重的精神痛苦、缩短预期寿命并增加自杀风险。最近,氯胺酮和埃斯氯胺酮等解离性迷幻物质在抑郁症治疗中的应用扩大了治疗方案的选择范围。我们试图通过一项系统性综述,分析现有的氯胺酮和埃斯氯胺酮治疗抑郁症的方案。检索采用了 PRISMA 标准,并使用了 PubMed 和 Web of Science 数据库。对每项研究的程序进行了比较,重点关注所招募的样本、治疗方法(包括参与治疗的临床团队和专业人员)、医疗程序、环境描述(包括音乐)以及特定药物(氯胺酮或埃斯氯胺酮)、给药途径和剂量等因素。研究结果表明,医疗方法占主导地位,而关于氯胺酮辅助心理疗法(KAP)和其他迷幻辅助疗法模式的研究数量有限。此外,有关心理社会因素的信息也很有限,如准备工作、治疗过程中的心理支持以及体验的整合。总之,这些研究结果表明,氯胺酮或伊斯氯胺酮治疗抑郁症的方法与使用迷幻剂的方法有所不同。考虑到该领域未来的研究方向,我们将对此进行讨论。
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来源期刊
CiteScore
5.30
自引率
7.10%
发文量
62
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