在希腊人群中使用埃斯卡他敏的结果;病例系列。

Q3 Medicine
Psychiatrike = Psychiatriki Pub Date : 2024-10-08 Epub Date: 2024-05-29 DOI:10.22365/jpsych.2024.006
Petros Fotiadis, Eleni Tsalkitzi, Dimos Dimellis, Konstantinos Rantis, Athanasios Tsimpiris, Georgios Pagkalos
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引用次数: 0

摘要

艾司卡明是大脑中N-甲基-D-天冬氨酸(NMDA)受体的一种非选择性、竞争性拮抗剂。通过NMDA受体拮抗作用,艾司卡胺能使谷氨酸释放短暂增加,从而增加神经营养信号传导,恢复大脑中涉及情绪调节和情感行为的区域的突触功能。几项随机临床试验表明,尽管它的短期副作用主要包括迷失方向、头晕、恶心和血压升高,但仍能有效减轻一些人的抑郁症状。2019年,美国食品和药物管理局(FDA)以及欧洲药品管理局批准将艾司氯胺酮鼻喷雾剂与口服抗抑郁药联合用于治疗成人耐药性抑郁症。我们的研究旨在评估这一新治疗方案在五名希腊耐药抑郁症患者中的疗效。在医生的指导下,患者在口服抗抑郁药的同时鼻内注射艾司氯胺酮。在三个时间点(基线、治疗结束和治疗后一年)使用蒙哥马利-阿斯伯格抑郁评定量表(MADRS)、患者健康问卷(PHQ-9)、CGI临床总体印象量表和抑郁知觉缺陷问卷(PDQ-D)对抑郁症状进行评估。使用里士满抑制躁动量表 (RASS)、希恩残疾量表 (SDS)、CADSS 破坏状态量表以及预定义的不良事件 (AE) 和严重不良事件 (SAE) 列表评估可能出现的副作用。患者按照个性化的治疗方案接受七到十二个月的治疗,具体取决于是否取得了充分的反应。统计分析结果显示,治疗效果显著改善(p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Results of esketamine administration in a Greek population; A case series.

Esketamine is a non-selective, competitive antagonist of the N-methyl-D-aspartate (NMDA) receptor in the brain. Through NMDA receptor antagonism, esketamine causes a transient increase in glutamate release, leading to increases in neurotrophic signaling and restoration of synaptic function in brain regions involved in mood regulation and emotional behavior. Several randomized clinical trials have shown its effectiveness in reducing the symptoms of depression in some people, despite its short-term side effects that include mainly disorientation, dizziness, nausea, and increased blood pressure. In 2019, the United States Food and Drug Administration (FDA) as well as the European Medicines Agency approved the use of esketamine nasal spray in combination with an oral antidepressant for treatment-resistant depression in adults. Our study aimed to evaluate the effectiveness of this new therapeutic proposal in a case series of five Greek patients with treatment- resistant depression. Intranasal esketamine was administered under medical supervision in combination with an oral antidepressant. Depressive symptoms were evaluated at three time points (baseline, end of treatment, and one-year post-treatment) using the Montgomery-Åsberg Depression Rating Scale (MADRS), the Patient Health Questionnaire (PHQ-9), the CGI Clinical Global Impression Scale, and the Perceived Deficits Questionnaire for Depression (PDQ-D). Possible side effects were assessed using the Richmond Suppression Agitation Scale (RASS), the Sheehan Disability Scale (SDS), the CADSS Disruptive States Scale, and a predefined list of adverse events (AEs) and serious adverse events (SAEs). Patients followed an individualized treatment plan for seven to twelve months depending on the achievement of an adequate response. Statistical analysis of the results revealed a significant improvement (p<0.05) on all scales used. All participants maintained their level of improvement at follow-up after twelve months. Adverse effects were found to be mild and tolerable. It is worth noting that significant side effects were reported only by the two patients with comorbid personality disorder. The results, despite limited to a small sample, indicate the positive effect of esketamine on the stable reduction of depressive symptoms among patients with resistant depression, even after the completion of treatment.

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来源期刊
Psychiatrike = Psychiatriki
Psychiatrike = Psychiatriki Medicine-Medicine (all)
CiteScore
2.60
自引率
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发文量
37
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