Ketamin in der Behandlung depressiver Episoden

Zusammenfassung

Ketamin, ein hochaffiner nicht kompetitiver Antagonist am glutamatergen N-Methyl-_D-Aspartat (NMDA-)Rezeptor zeigt potente und schnell wirksame antidepressive Effekte bei Patienten mit therapieresistenter unipolarer und bipolarer Depression. Dieser rasch einsetzende antidepressive Effekt konnte seit 2000 in vielen, wenn auch meist mit kleiner Fallzahl, randomisiert kontrollierten Studien gezeigt werden. Bis heute ist die Ketamingabe zur Behandlung depressiver Störungen eine Off-label-Behandlung. Behandlungsrichtlinien und -algorithmen im klinischen Umfeld sind ebenso wie mehr Forschung bezüglich der Beobachtung möglicher (nachteiliger) klinischer Langzeitwirkungen und Sicherheitsdaten von wiederholten Ketamingaben und -erhaltungstherapie nötig.

Summary

Ketamine, a high-affinity non-competitive antagonist at the glutamatergic N-methyl-_D-aspartate (NMDA) receptor has efficacious and rapid-acting antidepressant effects in patients with treatment-resistent unipolar or bipolar depression. Since 2000 these rapidacting antidepressant effects could be shown in several (small) randomized controlled studies. To date Ketamine administration for the treatment of depressive disorders is an off-label treatment. Treatment guidelines and -algorithms in clinical settings are needed, as well as more research in order to assess (adverse) clinical long-lasting effects and safety dates of repeated dosing and maintenance therapy.

Schlüsselwörter

Ketamin - NMDA-Rezeptorantagonist - rasche antidepressive Wirkung

Keywords

Ketamine - NMDA receptor antagonist - rapid-acting antidepressant

• Literatur

• 1 Inc SC. Product Monograph. QC, Canada: Sandoz Canada Inc.; 2015. Available from https://www. sandoz.ca/sites/www.sandoz.ca/files/Keta mine_HCl_PMe_20150506.pdf Accessed July 13, 2017.
• 2 Bausewein C, Remi C, Twycross RG. et al. (eds.). Arzneimitteltherapie in der Palliativmedizin. M–nchen: Urban & Fischer Verlag; 2014
• 3 Hocking G, Cousins MJ. Ketamine in chronic pain management: an evidence-based review. Anaesth Analg 2003; 97: 1730-1739.
• 4 Trivedi MH, Rush AJ, Wisniewski SR. et al STAR*D Study Team. Evaluation of outcomes with citalopram for depression using measurementbased care in STAR*D: implications for clinical practice. Am J Psychiatry 2006; 163: 28-40.
• 5 Berman RM, Cappiello A, Anand A, Oren DA, Heninger GR, Charney DS, Krystal JH. Antidepressant effects of ketamine in depressed patients. Biol Psychiatry 2000; 47 (04) 351-4.
• 6 Zarate Jr CA, Singh JB, Carlson PJ, Brutsche NE, Ameli R, Luckenbaugh DA, Charney DS, Manji HK. A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Arch Gen Psychiatry 2006; 63 (08) 856-64.
• 7 Diazgranados N. et al A randomized add-on trial of N-Methyl-D-aspartate antagonist in treatmentresistant bipolar depression. Arch Gen Psychiatry 2010; 67 (08) 793-802.
• 8 Newport DJ, Carpenter LL, McDonald WM, Potash JB, Tohen M, Nemeroff CB. APA Council of Reserach Task Force on novel biomarkers and treatments. Ketamine and other NMDA antagonists: early clinical trials and possible mechanisms in depression. Am J Psychiatry 2015; 172 (10) 950-966.
• 9 McGirr A, Berlim MT, Bond DJ, Fleck MP, Yatham LN, Lam RW. A systematic review and metaanalysis of randomized, double-blind, placebocontrolled trials of ketamine in the rapid treatment of major depressive episodes. Psychol Med 2015; 45: 693-704.
• 10 Sanacora G, Frye MA, McDonald W, Mathew SJ, Turner MS, Schatzberg AF, Summergrad P, Nemeroff CB. American Psychiatric Association (APA) Council of Research Task Force on Novel Biomarkers and Treatments. A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders. JAMA Psychiatry 2017; 74 (04) 399-405.
• 11 Wilkinson ST, Toprak M, Turner MS, Levine SP, Katz RB, Sanacora G. A survey of the clinical, offlabel use of ketamine as a treatment for psychiatric disorders. Am J Psychiatry 2017; 174 (07) 695-696.
• 12 Ballard ED. et al Improvement in suicidal ideation after ketamine infusion: relationship to reductions in depression and anxiety. J Psychiatr Res 2014; 58: 161-6.
• 13 Reinstatler L, Youssef NA. Ketamine as a potential treatment for suicidal ideation: a systematic review of the literature. Drugs R D 2015; 15: 37-43.
• 14 Wilkinson ST, Ballard ED, Bloch MH, Mathew SJ, Murrough JW, Feder A, Sos P, Wang G, Zarate Jr CA, Sanacora G. The effect of a single dose of intravenous ketamine on suicidal ideation: A systematic review and individual participant data metaanalysis. Am J Psychiatry 2018; 175 (02) 150-158.
• 15 Schwenk ES. et al Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists. Reg Anesth Pain Med 2018; 43 (05) 456-466.
• 16 Yoosefi A, Sepehri AS, Kargar M. et al Comparing effects of ketamine and thiopental administration during electroconvulsive therapy in patients with major depressive disorder: a randomized, doubleblind study. J ECT 2014; 30 (01) 15-21.
• 17 Salehi B, Mohammadbeigi A, Kamali AR, Taheri-Nejad MR, Moshiri I. Impact comparison of ketamine and sodium thiopental on anesthesia during electroconvulsive therapy in major depression patients with drug-resistant; a double-blind randomized clinical trial. Ann Card Anaesth 2015; 18 (04) 486-490.
• 18 Erdil F, Begec Z, Kayhan GE, Yologlu S, Ersoy MO, Durmus M. Effects of sevoflurane or ketamine on the QTc interval during electroconvulsive therapy. J Anesth 2015; 29 (02) 180-185.
• 19 Jarventausta K, Chrapek W, Kampman O. et al Effects of S-ketamine as an anesthetic adjuvant to propofol on treatment response to electroconvulsive therapy in treatment-resistant depression: a randomized pilot study. J ECT 2013; 29 (03) 158-161.
• 20 Rasmussen KG, Kung S, Lapid MI. et al A randomized comparison of ketamine versus methohexital anesthesia in electroconvulsive therapy. Psychiatry Res 2014; 215 (02) 362-365.
• 21 Anderson IM. et al Ketamine-ECT Study team. Ketamine augmentation of electroconvulsive therapy to improve neuropsychological and clinical outcomes in depression (Ketamine-ECT): a multicentre, double-blind, randomised, parallel-group, superiority trial. Lancet Psychiatry 2017; 4 (05) 365-377.
• 22 Jankauskas V, Necyk C, Chue J, Chue P. A review of ketamine–s role in ECT and non-ECT settings. Neuropsychiatr Dis Treat 2018; 14: 1437-1450.
• 23 aan het Rot M, Collins KA, Murrough JW, Perez AM, Reich DL, Charney DS, Mathew SJ. Safety and efficacy of repeated-dose intravenous ketamine for treatment-resistant depression. Biol Psychiatry 2010; 67 (02) 139-45.
• 24 Segmüller F, Rüther T, Linhardt A, Padberg F, Berger M, Pogarell O, Möller HJ, Kohler C, Sch le C. Repeated S-ketamine infusions in therapy resistant depression: a case series. J Clin Pharmacol 2013; 53 (09) 996-998.
• 25 van Schalkwyk GI, Wilkinson ST, Davidson L, Silverman WK, Sanacora G. Acute psychoactive effects of intravenous ketamine during treatment of mood disorders: Analysis of the Clinician Administered Dissociative State Scale. J Affect Disord 2018; 227: 11-16.
• 26 Jhang JF, Hsu YH, Kuo HC. Possible pathophysiology of ketamine-related cystitis and associated treatment strategies. Int J Urol 2015; 22 (09) 816-25.
• 27 Liu KM, Chuang SM, Long CY, Lee YL, Wang CC, Lu MC, Lin RJ, Lu JH, Jang MY, Wu J, Ho WT, 1 Juan YS. Ketamine-induced ulcerative cystitis and bladder apoptosis involve oxidative stress mediated by mitochondria and the endoplasmic reticulum. Am J Physiol Renal Physiol 2015; 309 (04) F318-31.
• 28 Morgan CJ, Muetzelfeldt L, Curran HV. Consequences of chronic ketamine self-administration Upon neurocognitive function and psychological wellbeing: a 1-year longitudinal study. Addiction 2010; 105: 121-133.
• 29 Sassano-Higgins S, Baron D, Juarez G, Esmaili N, Gold M. A review of ketamine abuse and diversion. Depress Anxiety 2016; 33: 718-727.
• 30 Sanacora G, Heimer H, Hartman D, Mathew SJ, Frye M, Nemeroff C, Robinson Beale R. Balancing the promise and risks of ketamine treatment for mood disorders. Neuropsychopharmacology 2016
• 31 Daly EJ, Singh JB, Fedgchin M. et al Intranasal esketamine in treatment resistant depression – a double-blind, randomized, efficacy and dose response study. Society of Biological Psychiatry–s (SOBP) 71st Annual Meeting; May 12-14. 2016. Atlanta, GA, USA:
• 32 Canuso C, Singh J, Fedgchin M. et al A novel study design to evaluate the rapid reduction of the symptoms of major depressive disorder, including suicidal ideation, in subjects assessed to be at imminent risk for suicide. Neuropsychopharmacology 2015; 40 (22) S480
• 33 Paslakis G, Gilles M, Meyer-Lindenberg A, Deuschle M. Oral administration of the NMDA receptor antagonist S-Ketamine as add-on therapy of depression: A case series. Pharmacopsychiatry 2010; 43: 33-35.
• 34 Jafarinia M, Afarideh M, Tafakhori A. et al Efficacy and safety of oral ketamine versus diclofenac to alleviate mild to moderate depression in chronic pain patients: a double-blind, randomized, controlled trial. J Affect Disord 2016; 204: 1-8.
• 35 Molero P, Ramos-Quiroga JA, Martin-Santos R, Calvo S nchez E, Guti rrez Rojas L, Meana JJ. Antidepressant efficacy and tolerability of ketamine and esketamine: A critical review. CNS Drugs 2018 May 7. doi: 10.1007/s40263-018–0519-3
• 36 Feder A, Parides MK, Murrough JW, Perez AM, Morgan JE, Saxena S, Kirkwood K, Aan Het Rot M, Lapidus KA, Wan LB, Iosifescu D, Charney DS. Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial. JAMA Psychiatry 2014; 71 (06) 681-8.
• 37 Albott CS, Lim KO, Forbes MK, Erbes CTye SJ, Grabowski JG, Thuras PBatres Y Carr TM, Wels J, Shiroma PR. Efficacy, safety, and durability of repeated ketamine infusions for comorbid posttraumatic stress disorder and treatment-resistant depression. J Clin Psychiatry 2018 79. 3
• 38 Szymkowicz SM, Finnegan N, Dale RM. A 12-month naturalistic observation of three patients receiving repeat intravenous ketamine infusions for their treatment-resistant depression. J Affect Disord 2013; 147 1-3. 416-20.
• 39 Blier P, Zigman D, Blier J. On the safety and benefits of repeated intravenous injections of ketamine for depression. Biol Psychiatry 2012; 72 (04) e11-2.
• 40 Archer S, Chrenek C, Swainson J. Maintenance ketamine therapy for treatment-resistant depression. J Clin Psychopharmacol 2018 Jun 14. doi: 10.1097/JCP.0000000000000894