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Ketamine의 속효성 항우울효과와 임상 적용Rapid-Acting Antidepressant Effect of Ketamine and Its Clinical Application

Other Titles
Rapid-Acting Antidepressant Effect of Ketamine and Its Clinical Application
Authors
김용구신철민
Issue Date
2018
Publisher
대한신경정신의학회
Keywords
Ketamine; Glutamate; N-methyl-D-aspartate receptor; Rapid-acting antidepressant; Depression.
Citation
신경정신의학, v.57, no.2, pp.108 - 118
Indexed
KCI
OTHER
Journal Title
신경정신의학
Volume
57
Number
2
Start Page
108
End Page
118
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/4118
DOI
10.4306/jknpa.2018.57.2.108
ISSN
1015-4817
Abstract
Although the biological causes of depression have been well established, the current use of antidepressants are still mostly based on the monoamine hypothesis of depression. However, monoamine antidepressants delay treatment of depression, and there is the problem of depressed patients who are resistant. Ketamine, a N-methyl-D-aspartate receptor (NMDAR) antagonist, is firstly introduced as an anesthetic. The hypothesis on the mechanism of ketamine as an antidepressant has been proposed through direct NMDAR inhibition, inhibition of γ-aminobutyric acid-ergic interneuron NMDARs and the role of ketamine metabolite (2R,6R)-hydroxynorcetamine (HNK). The ketamine also reverses the lack of synaptic connectivity and neurotrophic factors in depressed states by downstream mechanism of action. Through preclinical trials, there is a growing body of evidence indicating that ketamine has the potential for treatment of depression. In recent clinical studies, ketamine exhibits rapid-acting antidepressants effects and improvement of depression and even suicidality. This review examines current researches on molecular and cellular mechanisms of ketamine as an antidepressant, and reviews the current status of clinical studies, problems, and clinical applicability of ketamine.
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안산병원 (Department of Psychiatry, Ansan Hospital)
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