四川精神卫生2025，Vol.38Issue(4)：289-294,6.DOI:10.11886/scjsws20250531003
氯胺酮在精神疾病治疗中的研究进展
Advances in ketamine therapy for multiple psychiatric disorders
摘要
Abstract
Ketamine,a non-competitive N-methyl-D-aspartate(NMDA)receptor antagonist,has gained increasing attention for its rapid antidepressant effects in treatment-resistant depression(TRD)and suicidal ideation.Its mechanisms include NMDA receptor blockade,AMPA receptor activation,and upregulation of BDNF/mTOR signaling.Its enantiomers,esketamine and R-ketamine,as well as its metabolites,exhibit differences in efficacy and mechanisms.Intranasal esketamine has been approved in the Europe,United States,and China for TRD,demonstrating rapid efficacy in alleviating depressive symptoms and acute suicidal ideation.In contrast,R-ketamine demonstrates potential for longer-lasting effects and a improved safety profile.This review summarizes recent advances in the pharmacology,pharmacokinetics,and clinical applications of ketamine and its enantiomers in depressive disorders,bipolar disorder,substance use disorders,post-traumatic stress disorder and obsessive-compulsive disorder.Despite ketamine's multifaceted therapeutic potential,safety concerns such as dissociation,cognitive impairment,and abuse liability warrant continued attention.关键词
氯胺酮/艾司氯氨酮/快速抗抑郁/NMDA受体/精神疾病Key words
Ketamine/Esketamine/Rapid antidepressant/NMDA receptor/Psychiatric disorders分类
医药卫生引用本文复制引用
张凯,程朝阳,王雨婷..氯胺酮在精神疾病治疗中的研究进展[J].四川精神卫生,2025,38(4):289-294,6.基金项目
安徽省教育厅高校自然科学研究重点项目(项目名称:R-氯胺酮经小胶质细胞TGF-β-ERK/MAPK信号通路快速抗抑郁机制研究 （）
项目编号:2023AH050647) （）
安徽省教育厅2022年高校优秀青年人才支持计划项目(项目编号:gxyqZD2022022) Funded by Key Project of Natural Science Research for Universities of Anhui Provincial Education Department(number,2023AH050647) （项目编号:gxyqZD2022022）
Anhui Provincial Department of Education Outstanding Young Talent Support Program Project 2022(number,gxyqZD2022022) （number,gxyqZD2022022）
