Comparison of the Antianhedonic Effects of Repeated-dose Intravenous Ketamine in Older and Younger Adults with Major Depressive Episode.

IF 4.8 2区 医学 Q1 NEUROSCIENCES
Wei Zheng, Limei Gu, Jianqiang Tan, Yanling Zhou, Chengyu Wang, Xiaofeng Lan, Bin Zhang, Zezhi Li, Yuping Ning
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引用次数: 0

Abstract

Objectives: Growing evidence suggests that repeated-dose intravenous ketamine in patients with depression had rapid antianhedonic effects. However, a comparison of the antianhedonic effects of repeated-dose intravenous ketamine between younger adults and older depressed patients has not been examined.

Methods: To the best of my knowledge, this study with a total of 135 patients with major depressive episodes (MDE) is the first to compare the antianhedonic effects between younger adult (n = 116) and older (n = 19) depressed patients receiving six ketamine infusions (0.5 mg/kg over 40 min). Montgomery- Åsberg Depression Rating Scale (MADRS) was applied in this study to evaluate the clinical symptoms, and MADRS anhedonia item scoring was used to evaluate anhedonia symptoms.

Results: Patients received six open-label intravenous infusions of ketamine for 12 days. MADRS anhedonia subscale scores decreased in both younger (3.3, 95% CI = 2.5-4.1, p < 0.05) and older (2.8, 95% CI = 1.1-4.6, p < 0.05) MDE patients at 4h after the first infusion compared to baseline scores and the reduction was maintained over the subsequent infusion period in both groups (all Ps < 0.05). Younger MDE patients had lower MADRS anhedonia subscale scores on day 26 compared with older patients (P = 0.02). Compared with younger adult MDE patients, older patients had a lower antianhedonic response (51.7% [95% CI = 42.5%-61.0%] versus 31.6% [95% CI = 8.6%-54.6%)] and remission (24.1% [95% CI = 16.2%-32.0%] versus 0%).

Conclusion: This study indicates that repeated-dose intravenous ketamine administration induces rapid and robust antianhedonic effects in older MDE patients. However, older MDE patients displayed less response to ketamine than younger adult MDE patients.

比较重复剂量静脉注射氯胺酮对老年和青年重度抑郁发作患者的抗失眠作用
目的:越来越多的证据表明,对抑郁症患者反复静脉注射氯胺酮具有快速抗失眠的作用。然而,尚未对年轻成年人和老年抑郁症患者重复剂量静脉注射氯胺酮的抗失神作用进行比较:据我所知,这项研究共涉及 135 名重度抑郁发作(MDE)患者,是首次比较年轻成人抑郁症患者(116 人)和老年抑郁症患者(19 人)在接受六次氯胺酮输注(0.5 毫克/千克,40 分钟)后的抗失张力效果。本研究采用蒙哥马利-奥斯伯格抑郁评定量表(MADRS)评估临床症状,并采用MADRS失神项目评分法评估失神症状:结果:患者接受了6次氯胺酮静脉注射,为期12天。首次输注后4小时,年轻(3.3,95% CI = 2.5-4.1,P<0.05)和年长(2.8,95% CI = 1.1-4.6,P<0.05)的MDE患者的MADRS失乐症分量表评分与基线评分相比均有所下降,而且在随后的输注期间,两组患者的评分均保持下降趋势(所有Ps均<0.05)。与年龄较大的患者相比,年龄较小的 MDE 患者在第 26 天的 MADRS 抑郁症分量表评分较低(P = 0.02)。与年轻的成年 MDE 患者相比,老年患者的抗失神反应(51.7% [95% CI = 42.5%-61.0%] 对 31.6% [95% CI = 8.6%-54.6%] )和缓解(24.1% [95% CI = 16.2%-32.0%] 对 0%)较低:本研究表明,重复剂量静脉注射氯胺酮可对老年MDE患者产生快速、强效的抗失神作用。然而,老年 MDE 患者对氯胺酮的反应低于年轻的成年 MDE 患者。
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来源期刊
Current Neuropharmacology
Current Neuropharmacology 医学-神经科学
CiteScore
8.70
自引率
1.90%
发文量
369
审稿时长
>12 weeks
期刊介绍: Current Neuropharmacology aims to provide current, comprehensive/mini reviews and guest edited issues of all areas of neuropharmacology and related matters of neuroscience. The reviews cover the fields of molecular, cellular, and systems/behavioural aspects of neuropharmacology and neuroscience. The journal serves as a comprehensive, multidisciplinary expert forum for neuropharmacologists and neuroscientists.
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