Nervenheilkunde 2018; 37(09): 600-605
DOI: 10.1055/s-0038-1670570
Depression
Georg Thieme Verlag KG Stuttgart · New York

Ketamin in der Behandlung depressiver Episoden

Wirkung, Indikation, Durchführung – Wie macht man’s klinisch?Ketamine in the treatment of depression
M. Gilles
1   Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, AG Stress, Medizinische Fakultät Mannheim, Universität Heidelberg
,
M. Deuschle
1   Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, AG Stress, Medizinische Fakultät Mannheim, Universität Heidelberg
› Author Affiliations
Further Information

Publication History

eingegangen am: 04 July 2018

angenommen am: 26 July 2018

Publication Date:
29 August 2018 (online)

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.

 
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