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首页> 外文期刊>The journal of clinical psychiatry >Oral Ketamine for Depression, 2: Practical Considerations
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Oral Ketamine for Depression, 2: Practical Considerations

机译：口服氯胺酮抑郁症，2：实际考虑

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The oral route of administration is probably the least expensive and most convenient way to administer ketamine in indicated contexts in depressed patients. Because only 20%-25% of orally administered ketamine reaches systemic circulation, oral doses of about 2.0-2.5 mg/kg may need to be administered to achieve equivalence to intravenously administered ketamine. In case reports, case series, standard operating practice in ketamine facilities, and randomized controlled trials, oral ketamine has been administered through weight-based dosing and as fixed doses, and the dosing strategy has been one-size-fits-all or individualized through a dose discovery process. Administered doses have ranged from 0.25 to 7.0 mg/kg in weight-based dosing sessions and from 25 mg to 300 mg in fixed dosing sessions. This article reviews strategies for dosing with oral ketamine, dose discovery procedures, rates of dosing during a session, the frequency of dosing sessions and the duration of treatment, treatment in the clinic vs domiciliary treatment, adverse effects and risks, and safety issues. Finally, this article provides a detailed account of practices and experiences with oral ketamine so that readers may know what to expect when the treatment is orally administered. Whereas oral ketamine appears to be a safe and effective treatment and could make ketamine an accessible and affordable intervention in less privileged medical facilities, readers are warned that the literature on oral ketamine is thin and that there are many areas that need more investigation, especially matters related to pharmacokinetics, physiologic effects, abuse potential and strategies to mitigate illicit use, and adverse effects and efficacy relative to other routes of administration. Until studies of a sufficiently high quality become available, the use of oral ketamine to treat depression must be considered experimental.
机译：口腔给药途径可能是在抑郁症患者的表明上下文中施用氯胺酮的最便宜和最便捷的方法。由于只有20％-25％的口服氯胺酮达到全身循环，可能需要给予约2.0-2.5mg / kg的口服剂量以达到静脉内施用的氯胺酮。如果报告，案例系列，氯胺酮设施中的标准操作实践以及随机对照试验，通过基于体重的剂量和固定剂量给予口服氯胺酮，并且给药策略一直符合所有或个性化剂量发现过程。施用剂量在重量基给药季节中的0.25-7.0mg / kg范围为0.25-7.0mg / kg，在固定的计量期间为25mg至300mg。本文综述了用口服氯胺酮的给药策略，剂量发现程序，会议期间给药率，给药疗程的频率和治疗持续时间，在临床上的治疗与住宿治疗，不利影响和风险以及安全问题。最后，本文提供了具有口服氯胺酮的实践和经验的详细描述，以便读者在口服施用时可以知道预期。虽然口服氯胺酮似乎是一种安全有效的治疗方法，并且可以使氯胺酮在较少特权的医疗设施中获得可访问的和价格实惠的干预，读者被警告说，口腔氯胺酮的文献薄而较薄，需要更多的地区需要更多的调查，特别是重要的地区与药代动力学，生理效果，滥用潜力和策略相关，以减轻非法使用的不利影响和不同行政途径的不利影响和有效性。直到有足够高的质量的研究可用，必须考虑使用口服氯胺酮治疗抑郁症。

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