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Nervenheilkunde 2024; 43(06): 366-373
DOI: 10.1055/a-2309-6457
Schwerpunkt

Ketamin und Esketamin

Antidepressive pharmakologische Effekte und augmentierte PsychotherapieKetamine and esketamineAntidepressant pharmacologic effects and augmentative psychotherapy
Cornelius Schüle
1   Klinik für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München
,
Gabi Koller
2   Zentrum für Psychiatrie Reichenau, akad. Lehrkrankenhaus Universität Konstanz
,
Uwe Herwig
2   Zentrum für Psychiatrie Reichenau, akad. Lehrkrankenhaus Universität Konstanz
3   Klinik für Psychiatrie und Psychotherapie III, Universität Ulm
4   Psychiatrische Universitätsklinik Zürich
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ZUSAMMENFASSUNG

Ketamin blickt bereits auf eine längere Geschichte der Anwendung in der Psychiatrie zurück. Insbesondere ist es in den letzten 2 Dekaden zur Behandlung von therapieresistenten Depressionen erforscht und eingesetzt worden und ist mit dem Enantiomer Esketamin in Deutschland für diese Indikation zugelassen. Hier wird es vor allem als pharmakologische Intervention genutzt. Ketamin kann zudem als atypisches Psychedelikum oder Dissoziativum bezeichnet werden, da die Wirkung mit einer charakteristischen qualitativen Bewusstseinsänderung einhergeht. Insofern gibt es Ansätze, diese psychophänomenologische Wirkung therapeutisch im Sinne einer ketaminaugmentierten Psychotherapie zu nutzen. Dies ist aber mit der Studienlage nicht untermauert. Im Artikel werden zunächst pharmakologische Aspekte von Ketamin und Esketamin vorgestellt, dann aktuelle klinisch-psychiatrische Anwendungen und letztlich die Überlegung diskutiert, erlebte Bewusstseinsinhalte psychotherapeutisch einzubringen.

ABSTRACT

Ketamine already has a long history of use in psychiatry. It has been researched and used in the last two decades for the treatment of therapy-resistant depression and is also approved for this indication in Germany with the enantiomer esketamine. Here it is mainly used as a pharmacological intervention. Ketamine can also be described as an atypical psychedelic or dissociative, as the effect is accompanied by a characteristic qualitative change in consciousness. In this respect, there are also attempts to use this psychophenomenological effect therapeutically in the sense of ketamine-augmented psychotherapy. However, this has not been substantiated by studies to date. The article first presents pharmacological aspects of ketamine and esketamine, then discusses current clinical-psychiatric applications and finally the consideration of using experienced contents of consciousness in psychotherapy.

Schlüsselwörter

Ketamin - Esketamin - Psychedelika - Psychopharmakologie - Psychotherapie

Key words

Ketamine - esketamine - psychedelics - psychopharmacology - psychotherapy


Publication History

Article published online:
11 June 2024

© 2024. Thieme. All rights reserved.

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