Ketamine의 속효성 항우울효과와 임상 적용

• 영문명: Rapid-Acting Antidepressant Effect of Ketamine and Its Clinical Application
• 발행기관: 대한신경정신의학회
• 저자명: 김용구(Yong-Ku Kim) 신철민(Cheolmin Shin)
• 간행물 정보: 『신경정신의학』제57권 제2호, 108~118쪽, 전체 11쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2018.05.31

영문 초록

Although the biological causes of depression have been well established, the current use of antidepressants are still mostly based on the monoamine hypothesis of depression. However, monoamine antidepressants delay treatment of depression, and there is the problem of depressed patients who are resistant. Ketamine, a N-methyl-D-aspartate receptor (NMDAR) antagonist, is firstly introduced as an anesthetic. The hypothesis on the mechanism of ketamine as an antidepressant has been proposed through direct NMDAR inhibition, inhibition of γ-aminobutyric acid-ergic interneuron NMDARs and the role of ketamine metabolite (2R,6R)-hydroxynorcetamine (HNK). The ketamine also reverses the lack of synaptic connectivity and neurotrophic factors in depressed states by downstream mechanism of action. Through preclinical trials, there is a growing body of evidence indicating that ketamine has the potential for treatment of depression. In recent clinical studies, ketamine exhibits rapid-acting antidepressants effects and improvement of depression and even suicidality. This review examines current researches on molecular and cellular mechanisms of ketamine as an antidepressant, and reviews the current status of clinical studies, problems, and clinical applicability of ketamine.

목차

서론

우울증 약물치료의 현재 :단가아민 항우울제의 한계

글루타메이트와 우울증

Ketamine 항우울 작용의 기전

Ketamine의 항우울제 효과를 보여주는 임상 연구

Ketamine의 임상 활용에 있어서 주의해야 할 점

결론

키워드

Ketamine Glutamate N-methyl-D-aspartate receptor Rapid-acting antidepressant Depression