评估单剂量氯胺酮治疗重度抑郁症的疗效和副作用。

IF 3.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Postgraduate Medical Journal Pub Date : 2024-10-14 DOI:10.1093/postmj/qgae142
Betül Uyar, Mehmet Güneş
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引用次数: 0

摘要

目的:本研究旨在全面概述氯胺酮对单相抑郁症患者的抗抑郁和抗自杀疗效,重点关注其临床证据和安全性:我们的研究回顾性地评估了120名接受单剂量氯胺酮输注治疗的重度抑郁症患者的数据,包括治疗前、治疗后第4小时和第24小时临床医生使用的蒙哥马利-阿斯伯格抑郁评定量表(MADRS)以及治疗后4小时和24小时的副作用:所有参与者在输注氯胺酮前(第0小时)、输注氯胺酮后第4小时和第24小时的MADRS和MADRS-自杀评分差异有统计学意义。此外,男性和女性、RAT(+)和RAT(-)、SA(+)和SA(-)参与者在三个时间段的MADRS和MADRS-S评分均有显著统计学差异:本研究的结果与之前的研究结果一致,之前的研究表明氯胺酮具有快速、强效的抗抑郁作用,即使是对严重的难治性抑郁症患者也不例外。此外,鉴于急性自杀危机急需能够快速缓解的干预措施,因此观察到的自杀意念的减少尤其值得注意。关键信息 有关本课题的已知信息 - 氯胺酮对耐药性重度抑郁症具有快速抗抑郁和抗自杀作用,在用药后数小时内就能明显缓解症状。本研究的补充内容 - 本研究提供了更多证据,支持氯胺酮在减轻抑郁症状和自杀意念方面的快速疗效,突出显示了在治疗后4小时和24小时观察到的统计学意义上的显著改善。本研究对研究、实践或政策有何影响--研究结果可能会鼓励临床上更广泛地采用氯胺酮治疗急性抑郁发作和自杀倾向,强调需要在可控的医疗环境中控制潜在的副作用,并可能影响未来关于优化剂量方案和长期安全性的研究。
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An evaluation of the efficacy and side effects of a single dose of ketamine in major depressive disorder.

Aim: This study aims to provide a comprehensive overview of the antidepressant and antisuicidal efficacy of ketamine in patients with unipolar depression, with a focus on the clinical evidence and safety profile.

Material-method: In our study, the data of 120 major depressive disorder patients who received single-dose ketamine infusion therapy were evaluated retrospectively, with Montgomery-Asberg Depression Rating Scale (MADRS) applied by the clinician before treatment and at the 4th and 24th hours after treatment and side effects at 4 and 24 hours after treatment.

Results: There was a statistically significant difference between MADRS and MADRS-Suicide scores of all participants before the ketamine infusion (0th hour) and at the 4th and 24th hours after the ketamine infusion. Also, male and female, RAT(+) and RAT(-), and SA(+) and SA(-) participants have statistically significant differences on all three times for both MADRS and MADRS-S scores.

Conclusion: The findings of this study are in line with those from previous research that demonstrated the rapid and robust antidepressant effects of ketamine, even in individuals with severe, treatment-resistant depression. Moreover, the observed reduction in suicidal ideation is particularly noteworthy, given the critical need for interventions that can provide rapid relief in acute suicidal crises. Key message What is already known on this topic - Ketamine is known for its rapid antidepressant and antisuicidal effects in treatment-resistant major depressive disorder, demonstrating significant symptom relief within hours of administration. What this study adds - This study provides additional evidence supporting ketamine's rapid efficacy in reducing depressive symptoms and suicidal ideation, highlighting statistically significant improvements observed at 4 and 24 hours post-treatment. How this study might affect research, practice, or policy - The findings may encourage broader clinical adoption of ketamine for acute depressive episodes and suicidality, emphasizing the need for controlled medical settings to manage potential side effects, and could influence future research on optimizing dosing protocols and long-term safety.

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来源期刊
Postgraduate Medical Journal
Postgraduate Medical Journal 医学-医学:内科
CiteScore
8.50
自引率
2.00%
发文量
131
审稿时长
2.5 months
期刊介绍: Postgraduate Medical Journal is a peer reviewed journal published on behalf of the Fellowship of Postgraduate Medicine. The journal aims to support junior doctors and their teachers and contribute to the continuing professional development of all doctors by publishing papers on a wide range of topics relevant to the practicing clinician and teacher. Papers published in PMJ include those that focus on core competencies; that describe current practice and new developments in all branches of medicine; that describe relevance and impact of translational research on clinical practice; that provide background relevant to examinations; and papers on medical education and medical education research. PMJ supports CPD by providing the opportunity for doctors to publish many types of articles including original clinical research; reviews; quality improvement reports; editorials, and correspondence on clinical matters.
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