规范精神病学中氯胺酮的使用。

Lisa Harding
{"title":"规范精神病学中氯胺酮的使用。","authors":"Lisa Harding","doi":"10.29158/JAAPL.230040-23","DOIUrl":null,"url":null,"abstract":"Ketamine is a dissociative anesthetic that has gained attention in the field of psychiatry because of its unique mechanism of action and potential for treating treatment-resistant psychiatric disorders. It has been used off label for decades to treat depression, anxiety, and chronic pain. One of the most significant advancements has been the U.S. Food and Drug Administration’s (FDA) approval of esketamine, the S enantiomer of racemic ketamine, for treatmentresistant depression (TRD) and depression with acute suicidal ideation. Unlike traditional antidepressants, which can take several weeks to start working, esketamine and ketamine can begin to alleviate symptoms within hours of administration. Esketamine is also the only antidepressant of its kind to be studied and approved by the FDA for depressive symptoms in a suicidal population. Over the last five years there has been increased tension among medical providers regarding who is best suited to deliver care with ketamine and esketamine. Although the use of ketamine for depression and other psychiatric conditions has gained increasing attention, there is limited research available to support its use in many of the disorders for which it is used off label. Despite this lack of evidence, ketamine clinics have emerged as a popular alternative for patients who have not responded to traditional treatment options. In addition, the classification of the drug as a Schedule III (CIII) controlled substance and its potential for abuse and dependence raise significant concerns about its safety and appropriate use in medical settings. There is a pressing need for increased research and regulatory oversight into the potential risks and benefits of ketamine as a treatment for multiple psychiatric conditions. As the off-label use of ketamine for psychiatric disorders evolves as a therapeutic option, it is imperative that regulatory authorities promptly establish guidelines and regulations to promote its safe and effective use. This editorial examines the current state of knowledge regarding the use of ketamine and esketamine for psychiatric disorders and presents a framework for thinking through the challenges and opportunities for regulating the use of ketamine in psychiatry.","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":"51 3","pages":"320-325"},"PeriodicalIF":2.1000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Regulating Ketamine Use in Psychiatry.\",\"authors\":\"Lisa Harding\",\"doi\":\"10.29158/JAAPL.230040-23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Ketamine is a dissociative anesthetic that has gained attention in the field of psychiatry because of its unique mechanism of action and potential for treating treatment-resistant psychiatric disorders. It has been used off label for decades to treat depression, anxiety, and chronic pain. One of the most significant advancements has been the U.S. Food and Drug Administration’s (FDA) approval of esketamine, the S enantiomer of racemic ketamine, for treatmentresistant depression (TRD) and depression with acute suicidal ideation. Unlike traditional antidepressants, which can take several weeks to start working, esketamine and ketamine can begin to alleviate symptoms within hours of administration. Esketamine is also the only antidepressant of its kind to be studied and approved by the FDA for depressive symptoms in a suicidal population. Over the last five years there has been increased tension among medical providers regarding who is best suited to deliver care with ketamine and esketamine. Although the use of ketamine for depression and other psychiatric conditions has gained increasing attention, there is limited research available to support its use in many of the disorders for which it is used off label. Despite this lack of evidence, ketamine clinics have emerged as a popular alternative for patients who have not responded to traditional treatment options. In addition, the classification of the drug as a Schedule III (CIII) controlled substance and its potential for abuse and dependence raise significant concerns about its safety and appropriate use in medical settings. There is a pressing need for increased research and regulatory oversight into the potential risks and benefits of ketamine as a treatment for multiple psychiatric conditions. As the off-label use of ketamine for psychiatric disorders evolves as a therapeutic option, it is imperative that regulatory authorities promptly establish guidelines and regulations to promote its safe and effective use. This editorial examines the current state of knowledge regarding the use of ketamine and esketamine for psychiatric disorders and presents a framework for thinking through the challenges and opportunities for regulating the use of ketamine in psychiatry.\",\"PeriodicalId\":47554,\"journal\":{\"name\":\"Journal of the American Academy of Psychiatry and the Law\",\"volume\":\"51 3\",\"pages\":\"320-325\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American Academy of Psychiatry and the Law\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.29158/JAAPL.230040-23\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"LAW\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Academy of Psychiatry and the Law","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.29158/JAAPL.230040-23","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"LAW","Score":null,"Total":0}
引用次数: 0
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Regulating Ketamine Use in Psychiatry.
Ketamine is a dissociative anesthetic that has gained attention in the field of psychiatry because of its unique mechanism of action and potential for treating treatment-resistant psychiatric disorders. It has been used off label for decades to treat depression, anxiety, and chronic pain. One of the most significant advancements has been the U.S. Food and Drug Administration’s (FDA) approval of esketamine, the S enantiomer of racemic ketamine, for treatmentresistant depression (TRD) and depression with acute suicidal ideation. Unlike traditional antidepressants, which can take several weeks to start working, esketamine and ketamine can begin to alleviate symptoms within hours of administration. Esketamine is also the only antidepressant of its kind to be studied and approved by the FDA for depressive symptoms in a suicidal population. Over the last five years there has been increased tension among medical providers regarding who is best suited to deliver care with ketamine and esketamine. Although the use of ketamine for depression and other psychiatric conditions has gained increasing attention, there is limited research available to support its use in many of the disorders for which it is used off label. Despite this lack of evidence, ketamine clinics have emerged as a popular alternative for patients who have not responded to traditional treatment options. In addition, the classification of the drug as a Schedule III (CIII) controlled substance and its potential for abuse and dependence raise significant concerns about its safety and appropriate use in medical settings. There is a pressing need for increased research and regulatory oversight into the potential risks and benefits of ketamine as a treatment for multiple psychiatric conditions. As the off-label use of ketamine for psychiatric disorders evolves as a therapeutic option, it is imperative that regulatory authorities promptly establish guidelines and regulations to promote its safe and effective use. This editorial examines the current state of knowledge regarding the use of ketamine and esketamine for psychiatric disorders and presents a framework for thinking through the challenges and opportunities for regulating the use of ketamine in psychiatry.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
2.00
自引率
29.60%
发文量
92
期刊介绍: The American Academy of Psychiatry and the Law (AAPL, pronounced "apple") is an organization of psychiatrists dedicated to excellence in practice, teaching, and research in forensic psychiatry. Founded in 1969, AAPL currently has more than 1,500 members in North America and around the world.
期刊最新文献
Legal and Ethics Concerns of Psilocybin as Medicine. A Review of the Interpretation of the Canadian Test for Fitness to Stand Trial. Clinical and Legal Considerations When Optimizing Trauma Narratives in Immigration Law Evaluations. Flexibility and Innovation in Decisional Capacity Assessment. Mental Health Service Referral and Treatment Following Screening and Assessment in Juvenile Detention.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1