Abstract：
Ketamine, an N-methyl-D-aspartate receptor antagonist, is a racemic mixture of esketamine and arketamine used to treat unipolar and bipolar depression. Preliminary reports indicate that it may be beneficial for depressed patients reporting symptoms of anhedonia. In this systematic review we aim to assess and analyze the existing body of evidence regarding the therapeutic effects of ketamine on the domain of anhedonia. Electronic databases (PubMed, APA Psycinfo and Web of Science) were searched from inception to November 2023. Protocol was registered in PROSPERO under the identifier CRD42023476603. A total of twenty-two studies, including four randomized-controlled trials and eighteen open-label trials were included. All studies reported alleviation of anhedonia symptoms following ketamine or esketamine administration, regardless of the number of infusions. Several important limitations were included, first and foremost low number of placebo-controlled randomized-controlled trials. This review indicates a potential anti-anhedonic effect of ketamine in patients with depression. Several trials used neuroimaging techniques which confirm ketamine\'s effect on functional connectivity correlating with the improvement in anhedonia. Despite considerable variations in methodology and the specific brain regions investigated, these studies collectively point towards ketamine\'s neuroplastic effects in mitigating anhedonia.
摘要：
氯胺酮,一种N-甲基-D-天冬氨酸受体拮抗剂,是用于治疗单相和双相抑郁症的艾氯胺酮和阿氯胺酮的外消旋混合物。初步报告表明，它可能对报告快感缺失症状的抑郁症患者有益。在此系统评价中，我们旨在评估和分析有关氯胺酮对快感缺失的治疗作用的现有证据。电子数据库(PubMed，APAPsycinfo和WebofScience）从成立之初到2023年11月进行了搜索。协议在PROSPERO中以标识符CRD42023476603注册。共有22项研究,纳入4项随机对照试验和18项开放标签试验.所有研究都报告了氯胺酮或艾氯胺酮给药后快感缺失症状的缓解，不管输液的数量。包括几个重要的限制，首先，安慰剂对照随机对照试验数量少。这篇综述表明氯胺酮在抑郁症患者中具有潜在的抗内皮作用。一些试验使用神经成像技术证实氯胺酮对功能连接的影响与快感缺失的改善相关。尽管研究的方法和特定的大脑区域存在很大差异，这些研究共同指出氯胺酮在缓解快感缺乏方面的神经可塑性作用。
