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首页> 外文期刊>The journal of clinical psychiatry >Ketamine for Depression, 1: Clinical Summary of Issues Related to Efficacy, Adverse Effects, and Mechanism of Action
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Ketamine for Depression, 1: Clinical Summary of Issues Related to Efficacy, Adverse Effects, and Mechanism of Action

机译：抑郁症的氯胺酮，1：与疗效，不利影响和行动机制有关的问题的临床概要

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摘要

Ketamine is an anesthetic drug that is also used for off-label indications such as the mediation of analgesia and sedation in various settings. It is additionally recognized as an agent with antidepressant potential. For depression, it is most commonly administered as a slow intravenous infusion in subanesthetic doses (usually 0.5 mg/kg). As an antidepressant, is strikingly different from conventional antidepressant drugs in that it brings about rapid and marked attenuation of depressive symptoms even in patients with refractory depression. The benefits are observed within hours of administration, peak after about a day, and are lost 3-12 days later. Patients who do not benefit after the initial dose may benefit with serial dosing or at higher doses. Benefits can be maintained for weeks to months by the continuation of ketamine sessions at 2-to 4-day intervals. Adverse effects include dissociative and psychotomimetic changes that are almost always mild and transient, if present; transient elevation of heart rate and blood pressure often occur. These changes are usually well tolerated and are very seldom responsible for treatment discontinuation. Whereas ketamine is an N-methyl-D-aspartate receptor antagonist, and whereas much is known about its different biological effects, its actions that mediate the antidepressant response are presently not known for certain. Although big data on ketamine are presently unavailable, the drug holds promise in the treatment of depression, especially refractory depression. (C) Copyright 2017 Physicians Postgraduate Press, Inc.
机译：氯胺酮是一种麻醉药物，也用于标示外适应症，如在各种情况下调节镇痛和镇静。此外，它还被认为是一种具有抗抑郁潜力的药物。对于抑郁症，最常见的是以麻醉下剂量（通常为0.5 mg/kg）缓慢静脉输注。作为一种抗抑郁药，它与传统的抗抑郁药有着显著的不同，因为它能迅速显著地减轻抑郁症状，甚至对难治性抑郁症患者也是如此。在给药后数小时内观察到益处，大约一天后达到峰值，3-12天后消失。初次给药后没有受益的患者可能会受益于连续给药或更高剂量。每隔2到4天持续服用氯胺酮，可以维持数周到数月的疗效。副作用包括解离性和拟精神改变，如果存在，几乎总是轻微和短暂的；心率和血压的短暂升高经常发生。这些变化通常是可以很好地耐受的，很少与治疗中断有关。氯胺酮是一种N-甲基-D-天冬氨酸受体拮抗剂，虽然人们对其不同的生物学效应有很多了解，但其介导抗抑郁反应的作用目前尚不确定。虽然目前还没有关于氯胺酮的大数据，但该药物有望用于治疗抑郁症，尤其是难治性抑郁症。（C） 2017年医师研究生出版社版权所有。

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