Efficacy of ketamine versus esketamine in the treatment of perioperative depression: A review

IF 3.3 3区 心理学 Q1 BEHAVIORAL SCIENCES Pharmacology Biochemistry and Behavior Pub Date : 2024-05-26 DOI:10.1016/j.pbb.2024.173773
Wen Wen , Zhao Wenjing , Xing Xia, Xiangjun Duan, Liang Zhang, Lin Duomao, Qi Zeyou, Sheng Wang, Mingxin Gao, Changcheng Liu, Haiyang Li, Jun Ma
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Abstract

Depression is a significant factor contributing to postoperative occurrences, and patients diagnosed with depression have a higher risk for postoperative complications. Studies on cardiovascular surgery extensively addresses this concern. Several studies report that people who undergo coronary artery bypass graft surgery have a 20% chance of developing postoperative depression. A retrospective analysis of medical records spanning 21 years, involving 817 patients, revealed that approximately 40% of individuals undergoing coronary artery bypass grafting (CABG) were at risk of perioperative depression.

Patients endure prolonged suffering from illness because each attempt with standard antidepressants requires several weeks to be effective. In addition, multi-drug combination adjuvants or combination medication therapy may alleviate symptoms for some individuals, but they also increase the risk of side effects. Conventional antidepressants primarily modulate the monoamine system, whereas different therapies target the serotonin, norepinephrine, and dopamine systems. Esketamine is a fast-acting antidepressant with high efficacy. Esketamine is the S-enantiomer of ketamine, a derivative of phencyclidine developed in 1956. Esketamine exerts its effect by targeting the glutaminergic system the glutaminergic system. In this paper, we discuss the current depression treatment strategies with a focus on the pharmacology and mechanism of action of esketamine. In addition, studies reporting use of esketamine to treat perioperative depressive symptoms are reviwed, and the potential future applications of the drug are presented.

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氯胺酮与艾司氯胺酮治疗围手术期抑郁症的疗效对比:综述。
抑郁症是导致术后并发症的一个重要因素,被诊断出患有抑郁症的患者出现术后并发症的风险更高。有关心血管手术的研究广泛涉及这一问题。多项研究报告显示,接受冠状动脉旁路移植手术的患者术后患抑郁症的几率为 20%。一项对 817 名患者长达 21 年的医疗记录进行的回顾性分析表明,接受冠状动脉旁路移植术(CABG)的患者中约有 40% 存在围手术期抑郁的风险。由于每次尝试使用标准抗抑郁药都需要数周时间才能见效,因此患者要忍受长时间的疾病折磨。此外,多种药物联合辅助治疗或联合用药治疗可能会减轻某些人的症状,但也会增加副作用的风险。传统的抗抑郁药物主要调节单胺系统,而不同的疗法则针对血清素、去甲肾上腺素和多巴胺系统。Esketamine 是一种高效的速效抗抑郁药。Esketamine 是氯胺酮的 S-对映体,是 1956 年开发的苯环利定的衍生物。氯胺酮是氯胺酮的S-对映体,是1956年开发的苯环利定的衍生物。氯胺酮通过靶向谷氨酸能系统产生作用。在本文中,我们讨论了当前的抑郁症治疗策略,重点是艾司氯胺酮的药理学和作用机制。此外,本文还重温了使用艾司氯胺酮治疗围手术期抑郁症状的研究报告,并介绍了该药物未来的潜在应用领域。
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来源期刊
CiteScore
6.40
自引率
2.80%
发文量
122
审稿时长
38 days
期刊介绍: Pharmacology Biochemistry & Behavior publishes original reports in the areas of pharmacology and biochemistry in which the primary emphasis and theoretical context are behavioral. Contributions may involve clinical, preclinical, or basic research. Purely biochemical or toxicology studies will not be published. Papers describing the behavioral effects of novel drugs in models of psychiatric, neurological and cognitive disorders, and central pain must include a positive control unless the paper is on a disease where such a drug is not available yet. Papers focusing on physiological processes (e.g., peripheral pain mechanisms, body temperature regulation, seizure activity) are not accepted as we would like to retain the focus of Pharmacology Biochemistry & Behavior on behavior and its interaction with the biochemistry and neurochemistry of the central nervous system. Papers describing the effects of plant materials are generally not considered, unless the active ingredients are studied, the extraction method is well described, the doses tested are known, and clear and definite experimental evidence on the mechanism of action of the active ingredients is provided.
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