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Esketamine: new hope for the treatment of treatment-resistant depression? A narrative review

机译：eskeramine：治疗治疗抑郁症的新希望吗？叙述评论

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This narrative review aims to provide an overview of the current literature on the pharmacology, safety, efficacy and tolerability of intranasal esketamine, the S-enantiomer of ketamine, for the treatment of treatment-resistant depression (TRD). A literature search using Medline, Embase, PsycINFO and Cochrane Central was conducted (January 2000 to July 2019). Product information and www.clinicaltrials.gov were also reviewed. The literature search was limited to human studies published in English. Phase?I, II, and III studies of intranasal esketamine for TRD were reviewed. About a third of patients with major depressive disorder fail to achieve remission despite treatment with multiple antidepressants. This article examines the trials that led to the approval of esketamine in the United States, as well as other recent studies of esketamine for TRD. The findings from limited phase?III trials illustrate that intranasal esketamine is effective and safe in reducing depressive symptoms and achieving clinical response in patients with TRD. The optimum duration and frequency of use are not fully understood. Although the nasal spray is a convenient dosage form, its use in practice may be limited by cost and administrative regulation. While it may prove beneficial to many patients who suffer from TRD, further long-term data are required, along with comparative trials with the R-isomer (arketamine). In the interim, care and monitoring should be exercised in its use in clinical practice.
机译：这种叙述审查旨在概述当前文献，用于治疗治疗抑制（TRD）的治疗治疗抑制剂（TRD）的药理学，安全性，蛋白质酮肽的药理学，安全性，疗效和耐受性的概述。使用Medline，Embase，Psycinfo和Cochrane Central的文献搜索（2000年1月至2019年7月）。还审查了产品信息和www.clinicaltrials.gov。文献搜索仅限于英语发布的人类研究。综述了对TRD鼻内eskamine的II，II和III研究。尽管用多种抗抑郁药治疗，大约三分之一的重大抑郁症患者未能达到缓解。本文介绍了导致美国奥卡胺批准的试验，以及对TRD的eskamine的其他最新研究。有限相的研究结果表明，Intranasal eskeramine在降低抑郁症状和达到TRD患者的临床应答方面是有效和安全的。最佳使用持续时间和频率不完全理解。虽然鼻喷雾是一种方便的剂型，但其在实践中的使用可能受到成本和行政监管的限制。虽然它可能对许多患有TRD的患者证明有益，但需要进一步的长期数据，以及与R-异构体（Arketamine）的对比试验。在临时，护理和监测应该在其在临床实践中使用。

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