Am J Psychiatry：重复使用氯胺酮治疗慢性创伤后应激障碍的疗效和安全性如何？

2021-06-25 MedSci原创 MedSci原创

创伤后应激障碍（PTSD）是一种慢性和致残性疾病，现有的药物治疗方法对其疗效有限。研究人员曾发现，氯胺酮注射后24小时内创伤后应激障碍症状明显快速减轻，为测试反复静脉注射氯胺酮治疗慢性PTSD的疗效和

创伤后应激障碍（PTSD）是一种慢性和致残性疾病，现有的药物治疗方法对其疗效有限。研究人员曾发现，氯胺酮注射后24小时内创伤后应激障碍症状明显快速减轻，为测试反复静脉注射氯胺酮治疗慢性PTSD的疗效和安全性，研究人员又开展了一项随机对照试验，研究结果已发表于Am J Psychiatry。

将30名PTSD患者随机分配（1:1），连续两周内输注接受六次氯胺酮（0.5毫克/千克）或咪达唑仑（0.045毫克/千克）（精神活性安慰剂对照）。在第一次输液后24小时和每周访问时进行临床医生评分和自我报告评估。主要结果测量是CAPS-5评估PTSD症状严重程度从基线至治疗2周后变化。次要结果指标包括事件影响量表-改良版、MADRS和副作用。

结果显示，从基线到第2周，氯胺酮组在CAPS-5和MADRS总分上的改善明显大于咪达唑仑组。在第2周，氯胺酮组的平均CAPS-5总分比咪达唑仑组低11.88分（SE=3.96）（d=1.13，95%CI=0.36，1.91）。在氯胺酮组中，67%的参与者对治疗有反应，而咪达唑仑组中只有20%。在氯胺酮应答者中，在为期2周的输液过程中，失去应答的中位时间为27.5天。氯胺酮输液总体上耐受性良好，没有严重的不良事件。

综上，这项随机对照试验首次提供了反复输注氯胺酮对减少慢性创伤后应激障碍患者的症状严重程度的证据。需要进一步研究以了解氯胺酮作为慢性创伤后应激障碍治疗的全部潜力。

原始出处：

Adriana Feder, et al., A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder. Am J Psychiatry. 2021 Feb 1;178(2):193-202. doi: 10.1176/appi.ajp.2020.20050596.

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2021-09-29 经常头晕

#疗效和安全性#

77 0
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2021-11-24 diushouji

#Psychiatry#

74 0
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2021-06-27 jml2009

#氯胺酮#

94 0
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2021-06-27 ms920641618706883

#创伤#

74 0
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2021-06-27 ms1260584454294838

#应激#

72 0
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2021-06-25 内科新手

谢谢梅斯提供这么好的信息，学到很多

109 0
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2021-06-25 wxl882001

了解

145 0
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2021-06-25 易水河

学习学习

125 0
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2021-06-25 ms7000001243606725

非常实用

132 0

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