氯胺酮在抗抑郁治疗领域里的最新研究进展

The Latest Research Progress of Ketamine in the Field of Antidepressant Treatment

摘要: 目的：欲了解有关氯胺酮对抑郁症状的疗效和作用机制探讨的进展。方法：收集近几十年来在几个常用医学搜素网站上发表的有关氯胺酮及其衍生物，针对难治性抑郁症产生快速起效和相关作用机制探讨的文章。结果：共收集来源于PubMed、Medline等医学文献数据库的相关文章18篇，其中综述类文章4篇，作为重点汇总分析。结论：氯胺酮及其衍生物艾司氯胺酮具有快速起效的抗抑郁效果。成人有效剂量在0.5毫克~1.0毫克/公斤体重，单次静脉注射时间不少于40分钟。平均起效时间1.5小时，达峰时间3小时。鼻腔内喷雾给药效果相似。口服该药和儿童慎用。作用机制仍然不甚明了。需要进一步观察长期用药带来的风险。

Abstract: Objective: To probe about the progress in the efficacy and mechanism of Ketamine in the treatment of depression. Methods: We collected articles on search websites in recent decades on the rapid on-set and related mechanisms of Ketamine and Esketamine in the treatment-refractory depression. Results: A total of 18 relevant articles were collected from the PubMed, Medline etc. website medi-cal literature database, including 4 review articles, as a key summary and analysis. Conclusion: Ketamine and Esketamine have a rapid antidepression effect. The effective dose for adults is be-tween 0.5~1.0 milligrams per kilogram of body weight, with a single injection time of no less than 40 minutes. The average onset time is 1.5 hour and the peak time is 3 hours. Intranasal spray has similar efficacy and oral administration is ineffective and should be used with caution in children. The mechanism of action is still unclear. Further observation is needed on the risks associated with long-term medication use.