Ketamin – Eine neue Option in der Behandlung der therapieresistenten Depression

Zusammenfassung

In den letzten zwei Jahren konnte für das Anästhetikum Ketamin in mehreren doppelblind-kontrollierten Untersuchungen ein antidepressiver Effekt nachgewiesen werden. Für Patienten mit schwerer therapieresistenter Depression konnten Response-Raten von bis zu 70 % nach einmaliger intravenöser Gabe erreicht werden. Im Unterschied zu allen zur Verfügung stehenden antidepressiven Behandlungsmethoden zeigte sich dieser robuste antidepressive Effekt bereits 24 Stunden nach der Infusion. Dem gegenüber steht jedoch eine zeitlich begrenzte Wirksamkeit einer Ketaminbehandlung mit Rezidivraten von bis zu 70 % innerhalb von zwei Wochen nach der Behandlung. Der vorliegende Artikel gibt einen Überblick sowohl über die klinischen Studien zur Wirksamkeit von Ketamin in der Behandlung depressiver Störungen als auch über antidepressive Wirkfaktoren von Ketamin und über aktuelle Studien und praktische Hinweise.

Abstract

The anaesthetic ketamine has been demonstrated to have an antidepressive effect in several randomised controlled studies. Patients with a severe therapy-resistant depression showed response rates of up to 70 % after one single ketamine infusion. In contrast to all other antidepressant treatment options, this effect was already apparent at 24 hours post infusion. However, the antidepressant effect is limited and after two weeks the relapse rate is around 70 %. This review gives a summary of the clinical value of ketamine in the treatment of depression focussing on clinical trials and the therapeutic mechanism of action.

Schlüsselwörter

Ketamin - Depression - Therapieresistenz

Key words

ketamine - depression - treatment resistance

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