PDF(Pubmed)
Abstract：
(R, S)- and (S)-ketamine have made significant progress in the treatment of treatment-resistant depression (TRD) and have become a research focus in recent years. However, they both have risks of psychomimetic effects, dissociative effects, and abuse liability, which limit their clinical use. Recent preclinical and clinical studies have shown that (R)-ketamine has a more efficient and lasting antidepressant effect with fewer side effects compared to (R, S)- and (S)-ketamine. However, a recent small-sample randomized controlled trial found that although (R)-ketamine has a lower incidence of adverse reactions in adult TRD treatment, its antidepressant efficacy is not superior to the placebo group, indicating its antidepressant advantage still needs further verification and clarification. Moreover, an increasing body of research suggests that (R)-ketamine might also have significant applications in the prevention and treatment of medical fields or diseases such as cognitive disorders, perioperative anesthesia, ischemic stroke, Parkinson\'s disease, multiple sclerosis, osteoporosis, substance use disorders, inflammatory diseases, COVID-19, and organophosphate poisoning. This article briefly reviews the mechanism of action and research on antidepressants related to (R)-ketamine, fully revealing its application potential and development prospects, and providing some references and assistance for subsequent expanded research.
摘要：
(R,S)-和(S)-氯胺酮在治疗难治性抑郁症(TRD)方面取得了重大进展,成为近年来的研究热点。然而,他们都有心理模拟效应的风险，解离效应，和滥用责任，这限制了它们的临床应用。最近的临床前和临床研究表明，（R）-氯胺酮与（R，S)-和(S)-氯胺酮。然而,最近的一项小样本随机对照试验发现，尽管（R）-氯胺酮在成人TRD治疗中的不良反应发生率较低，其抗抑郁疗效并不优于安慰剂组，表明其抗抑郁优势仍需进一步验证和澄清。此外，越来越多的研究表明，（R）-氯胺酮也可能在预防和治疗医学领域或疾病，如认知障碍，围手术期麻醉,缺血性卒中,帕金森病,多发性硬化症,骨质疏松,物质使用障碍，炎症性疾病，COVID-19和有机磷中毒。本文简要综述了(R)-氯胺酮抗抑郁药的作用机制及相关研究,充分揭示其应用潜力和发展前景，为后续拓展研究提供一定的参考和帮助。
