Ketamina oral para tratamiento rápido de la depresión y ansiedad en pacientes que reciben manejo en hospicios
Oral ketamine for the rapid treatment of depression and anxiety in patients receiving hospice care.
Irwin SA, Iglewicz A.
Institute for Palliative Medicine at San Diego Hospice, Palliative Care Psychiatry, San Diego, California 92103, USA. sirwin@sdhospice.org
J Palliat Med. 2010 Jul;13(7):903-8. doi: 10.1089/jpm.2010.9808.
Abstract
Depression is prevalent and undertreated in patients receiving hospice care. Standard antidepressants do not work rapidly or often enough to benefit most of these patients. Here, two cases are reported in which a single oral dose of ketamine provided rapid and moderately sustained symptom relief for both depression and anxiety. In addition, no adverse effects were noted. Further investigation with randomized, controlled clinical trials is necessary to firmly establish the effectiveness of oral ketamine for the treatment of depression and anxiety in patients receiving hospice care. Ketamine may be a promising safe, effective, and cost-effective rapid treatment for depression and anxiety in this population.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120058/pdf/jpm.2010.9808.pdf
El bloqueo del receptor NMDA en reposo desencadena respuestas antidepresivas conductuales rápidas
NMDA receptor blockade at rest triggers rapid behavioural antidepressant responses.
Autry AE, Adachi M, Nosyreva E, Na ES, Los MF, Cheng PF, Kavalali ET, Monteggia LM.
Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9111, USA.
Nature. 2011 Jun 15;475(7354):91-5. doi: 10.1038/nature10130.
Abstract
Clinical studies consistently demonstrate that a single sub-psychomimetic dose of ketamine, an ionotropic glutamatergic NMDAR (N-methyl-D-aspartate receptor) antagonist, produces fast-acting antidepressant responses in patients suffering from major depressive disorder, although the underlying mechanism is unclear. Depressed patients report the alleviation of major depressive disorder symptoms within two hours of a single, low-dose intravenous infusion of ketamine, with effects lasting up to two weeks, unlike traditional antidepressants (serotonin re-uptake inhibitors), which take weeks to reach efficacy. This delay is a major drawback to current therapies for major depressive disorder and faster-acting antidepressants are needed, particularly for suicide-risk patients. The ability of ketamine to produce rapidly acting, long-lasting antidepressant responses in depressed patients provides a unique opportunity to investigate underlying cellular mechanisms. Here we show that ketamine and other NMDAR antagonists produce fast-acting behavioural antidepressant-like effects in mouse models, and that these effects depend on the rapid synthesis of brain-derived neurotrophic factor. We find that the ketamine-mediated blockade of NMDAR at rest deactivates eukaryotic elongation factor 2 (eEF2) kinase (also called CaMKIII), resulting in reduced eEF2 phosphorylation and de-suppression of translation of brain-derived neurotrophic factor. Furthermore, we find that inhibitors of eEF2 kinase induce fast-acting behavioural antidepressant-like effects. Our findings indicate that the regulation of protein synthesis by spontaneous neurotransmission may serve as a viable therapeutic target for the development of fast-acting antidepressants.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172695/pdf/nihms313008.pdf
Abordajes innovadores para el manejo de la depresión refractaria. La historia de la ketamina
Innovative approaches to treatment - refractory depression: The ketamine story.
Rao TS, Andrade C.
Indian J Psychiatry. 2010 Apr;52(2):97-9. doi: 10.4103/0019-5545.64573.
Antidepressant drugs have traditionally addressed the monoamine triumvirate: serotonin, noradrenaline, and dopamine. There have been predominantly two mechanisms recruited in drug action - inhibition of monoamine reuptake and inhibition of intravesicular monoamine catabolism. Tianeptine, which increases the synaptic reuptake of serotonin, and mirtazapine, which blocks alpha-2 adrenergic autoreceptors and heteroreceptors, are examples of the very few drugs which have other mechanisms of action. Yet, even these two antidepressants target the traditional neurotransmitters in psychiatry
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2927899/
Ketamina para el tratamiento de la depresión
Ketamine for the treatment of depression
Robert H. Howland
Journal of Psychosocial Nursing * Vol. 51, No. 1, 2013
http://www.healio.com/~/media/Journals/JPN/2013/1_January/10_3928_02793695
_20121219_01/10_3928_02793695_20121219_01.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Oral ketamine for the rapid treatment of depression and anxiety in patients receiving hospice care.
Irwin SA, Iglewicz A.
Institute for Palliative Medicine at San Diego Hospice, Palliative Care Psychiatry, San Diego, California 92103, USA. sirwin@sdhospice.org
J Palliat Med. 2010 Jul;13(7):903-8. doi: 10.1089/jpm.2010.9808.
Abstract
Depression is prevalent and undertreated in patients receiving hospice care. Standard antidepressants do not work rapidly or often enough to benefit most of these patients. Here, two cases are reported in which a single oral dose of ketamine provided rapid and moderately sustained symptom relief for both depression and anxiety. In addition, no adverse effects were noted. Further investigation with randomized, controlled clinical trials is necessary to firmly establish the effectiveness of oral ketamine for the treatment of depression and anxiety in patients receiving hospice care. Ketamine may be a promising safe, effective, and cost-effective rapid treatment for depression and anxiety in this population.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120058/pdf/jpm.2010.9808.pdf
El bloqueo del receptor NMDA en reposo desencadena respuestas antidepresivas conductuales rápidas
NMDA receptor blockade at rest triggers rapid behavioural antidepressant responses.
Autry AE, Adachi M, Nosyreva E, Na ES, Los MF, Cheng PF, Kavalali ET, Monteggia LM.
Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9111, USA.
Nature. 2011 Jun 15;475(7354):91-5. doi: 10.1038/nature10130.
Abstract
Clinical studies consistently demonstrate that a single sub-psychomimetic dose of ketamine, an ionotropic glutamatergic NMDAR (N-methyl-D-aspartate receptor) antagonist, produces fast-acting antidepressant responses in patients suffering from major depressive disorder, although the underlying mechanism is unclear. Depressed patients report the alleviation of major depressive disorder symptoms within two hours of a single, low-dose intravenous infusion of ketamine, with effects lasting up to two weeks, unlike traditional antidepressants (serotonin re-uptake inhibitors), which take weeks to reach efficacy. This delay is a major drawback to current therapies for major depressive disorder and faster-acting antidepressants are needed, particularly for suicide-risk patients. The ability of ketamine to produce rapidly acting, long-lasting antidepressant responses in depressed patients provides a unique opportunity to investigate underlying cellular mechanisms. Here we show that ketamine and other NMDAR antagonists produce fast-acting behavioural antidepressant-like effects in mouse models, and that these effects depend on the rapid synthesis of brain-derived neurotrophic factor. We find that the ketamine-mediated blockade of NMDAR at rest deactivates eukaryotic elongation factor 2 (eEF2) kinase (also called CaMKIII), resulting in reduced eEF2 phosphorylation and de-suppression of translation of brain-derived neurotrophic factor. Furthermore, we find that inhibitors of eEF2 kinase induce fast-acting behavioural antidepressant-like effects. Our findings indicate that the regulation of protein synthesis by spontaneous neurotransmission may serve as a viable therapeutic target for the development of fast-acting antidepressants.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172695/pdf/nihms313008.pdf
Abordajes innovadores para el manejo de la depresión refractaria. La historia de la ketamina
Innovative approaches to treatment - refractory depression: The ketamine story.
Rao TS, Andrade C.
Indian J Psychiatry. 2010 Apr;52(2):97-9. doi: 10.4103/0019-5545.64573.
Antidepressant drugs have traditionally addressed the monoamine triumvirate: serotonin, noradrenaline, and dopamine. There have been predominantly two mechanisms recruited in drug action - inhibition of monoamine reuptake and inhibition of intravesicular monoamine catabolism. Tianeptine, which increases the synaptic reuptake of serotonin, and mirtazapine, which blocks alpha-2 adrenergic autoreceptors and heteroreceptors, are examples of the very few drugs which have other mechanisms of action. Yet, even these two antidepressants target the traditional neurotransmitters in psychiatry
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2927899/
Ketamina para el tratamiento de la depresión
Ketamine for the treatment of depression
Robert H. Howland
Journal of Psychosocial Nursing * Vol. 51, No. 1, 2013
http://www.healio.com/~/media/Journals/JPN/2013/1_January/10_3928_02793695
_20121219_01/10_3928_02793695_20121219_01.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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