氯胺酮的改变状态元分析:精神模拟与临床效应之间的关系,聚焦抑郁症。

IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Journal of Clinical Psychopharmacology Pub Date : 2025-03-01 Epub Date: 2024-12-23 DOI:10.1097/JCP.0000000000001946
Vagner Deuel de O Tavares, Kaike Thiê da Costa Gonçalves, Maria Luiza de Morais Barros, Aldielyson Jorge Cavalcante de Brito, Patrícia Cavalcanti-Ribeiro, Fernanda Palhano-Fontes, Marcelo Falchi-Carvalho, Emerson Arcoverde Nunes, Jerome Sarris, Daniel Perkins, Gisele Fernandes-Osterhold, Draulio Barros de Araujo, Nicole Leite Galvão-Coelho
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引用次数: 0

摘要

背景:近年来,人们一直关注于探索意识状态改变对精神疾病治疗结果的潜在治疗影响,以提高治疗策略和患者的治疗效果。方法:本荟萃分析旨在研究氯胺酮的拟心理效应与心理健康临床结果之间的潜在联系,遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目。结果:11项研究被纳入荟萃分析,主要结果未发现氯胺酮的精神活性作用与精神疾病的临床结局之间存在显著相关性(n = 11;N = 27;R = 0.06 [-0.05, 0.17];P = 0.268)或完全抑郁(n = 10;N = 25;R = 0.03 [-0.07, 0.13];P = 0.561)。一般分析发现高度异质性(I2 = 80.78)。Egger’s回归未显示发表偏倚(截距= 1.57;Se = 1.49, p = 0.30)。未观察到显著的Kendall等级相关系数(τ = 0.02, P = 0.88),表明漏斗图对称。亚分析的目的是通过具体检查诸如患者疾病(仅限于抑郁症)、给药方法(完全静脉注射)、评估工具类型和评估时间等因素来最大限度地减少研究的可变性,但也没有显著的发现。结论:这项荟萃分析表明,氯胺酮治疗期间意识状态的改变与临床结果没有直接联系。然而,重要的是要认识到,有限的研究数量和它们的异质性使得这个结论是初步的,需要随着时间的推移进一步调查。
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Ketamine's Altered States Meta-Analysis: The Relationship Between Psychomimetic and Clinical Effects With Focus in Depression.

Background: In recent years, there has been a significant focus on exploring the potential therapeutic impact of altered states of consciousness on treatment outcomes for mental illness, with the goal of enhancing therapeutic strategies and patient results.

Methods: This meta-analysis was designed to investigate the potential link between the psychomimetic effects of ketamine and clinical outcomes in mental health, which adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: Eleven studies were selected for meta-analysis, and the main result did not find a significant correlation between the psychoactive effects of ketamine and clinical outcomes either in mental illness (n = 11; n's = 27; r = 0.06 [-0.05, 0.17]; P = 0.268) or depression exclusively (n = 10; n's = 25; r = 0.03 [-0.07, 0.13]; P = 0.561). High heterogeneity was found for general analysis ( I2 = 80.78). Egger's regression did not indicate publication bias (intercept = 1.57; SE = 1.49, P = 0.30). No significant Kendall's rank correlation coefficient was observed ( τ = 0.02, P = 0.88) indicating funnel plot symmetry. The sub-analyses, aimed at minimizing study variability by specifically examining factors such as patient disorders (limited to depression), methods of administration (exclusively intravenous), types of assessment instruments, and the timing of evaluations, also yielded no significant findings.

Conclusion: This meta-analysis suggests that the altered states of consciousness experienced during ketamine sessions are not directly linked to clinical outcomes. However, it is important to acknowledge that the limited number of studies and their heterogeneity render this conclusion preliminary, warranting further investigation over time.

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来源期刊
CiteScore
4.00
自引率
3.40%
发文量
231
审稿时长
4-8 weeks
期刊介绍: Journal of Clinical Psychopharmacology, a leading publication in psychopharmacology, offers a wide range of articles reporting on clinical trials and studies, side effects, drug interactions, overdose management, pharmacogenetics, pharmacokinetics, and psychiatric effects of non-psychiatric drugs. The journal keeps clinician-scientists and trainees up-to-date on the latest clinical developments in psychopharmacologic agents, presenting the extensive coverage needed to keep up with every development in this fast-growing field.
期刊最新文献
Differentiating Depressive Symptoms From Side Effects in Individuals With Major Depressive Disorder With Postpartum Onset. Recognition of Clozapine-Associated Eosinopenia in Patients With Treatment-Resistant Schizophrenia: A Report of 3 Cases and Literature Review. Blonanserin-Associated Leukopenia: Two Case Reports. Ketamine's Altered States Meta-Analysis: The Relationship Between Psychomimetic and Clinical Effects With Focus in Depression. A Case of Tacrolimus-Associated Psychosis.
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