Abstract：
BACKGROUND: Major depressive disorder (MDD) can have severe impacts on function and quality of life. Up to one third of patients will have an inadequate response to their first line of treatment, with subsequent lines of therapy associated with lower remission rates and higher relapse rates. Recently esketamine has become available for Australian patients, and this agent provides an additional treatment option for those with MDD who have had an inadequate response to two or more antidepressant therapies during the current moderate to severe depressive episode. This paper provides an expert panel\'s practical recommendations and clinical guidance for establishing esketamine clinics in Australia.
METHODS: An expert panel (n = 11) comprising psychiatrists, mental health care nurses, pharmacists, and individuals with experience establishing esketamine clinics was convened in Sydney. The panel developed practical recommendations and clinical guidance, which were then further refined.
RESULTS: Five key areas were identified: practical considerations for esketamine clinic set-up, including multidisciplinary care considerations; patient selection; administering esketamine; adverse event management and long-term follow-up.
CONCLUSIONS: Guidance presented in this paper should assist Australian clinicians to set up an esketamine clinic, and provide practical advice on the infrastructure and clinical requirements for treatment of patients with this agent.
METHODS: An expert panel (n = 11) comprising psychiatrists, mental health care nurses, pharmacists, and individuals with experience establishing esketamine clinics was convened in Sydney. The panel developed practical recommendations and clinical guidance, which were then further refined.
RESULTS: Five key areas were identified: practical considerations for esketamine clinic set-up, including multidisciplinary care considerations; patient selection; administering esketamine; adverse event management and long-term follow-up.
CONCLUSIONS: Guidance presented in this paper should assist Australian clinicians to set up an esketamine clinic, and provide practical advice on the infrastructure and clinical requirements for treatment of patients with this agent.
摘要：
背景：重度抑郁症（MDD）可对功能和生活质量产生严重影响。多达三分之一的患者对他们的一线治疗反应不足，随后的治疗路线与较低的缓解率和较高的复发率相关。最近，澳大利亚患者可以使用esketamine，这种药物为在目前的中度至重度抑郁发作期间对两种或两种以上抗抑郁药反应不足的MDD患者提供了额外的治疗选择.本文为在澳大利亚建立艾氯胺酮诊所提供专家小组的实用建议和临床指导。
方法：由精神科医生组成的专家小组（n=11），精神卫生保健护士，药剂师,并在悉尼召集了有建立esketamine诊所经验的个人。小组制订了切实可行的建议和临床指导,然后进一步完善。
结果：确定了五个关键领域：艾氯胺酮诊所设置的实际考虑，包括多学科护理考虑因素；患者选择；给予艾氯胺酮；不良事件管理和长期随访。
结论：本文提供的指南应有助于澳大利亚临床医生建立esketamine诊所，并就使用该药物治疗患者的基础设施和临床要求提供实用建议。
方法：由精神科医生组成的专家小组（n=11），精神卫生保健护士，药剂师,并在悉尼召集了有建立esketamine诊所经验的个人。小组制订了切实可行的建议和临床指导,然后进一步完善。
结果：确定了五个关键领域：艾氯胺酮诊所设置的实际考虑，包括多学科护理考虑因素；患者选择；给予艾氯胺酮；不良事件管理和长期随访。
结论：本文提供的指南应有助于澳大利亚临床医生建立esketamine诊所，并就使用该药物治疗患者的基础设施和临床要求提供实用建议。
