结合鼻腔内 squetamine 和电疗法在严重的治疗耐药抑郁症:一个案例系列
Sergi López-Rodríguez1,2,3,4, Aida de Arriba-Arnau1,2,3,4, José Manuel Menchón1,2,3,4
1Department of Psychiatry, Interventional Psychiatry and Neuromodulation Unit, Bellvitge University Hospital.
The journal of ECT
|January 29, 2026
概括
结合电疗法 (ECT) 与鼻内胺 (ESK) 显示,治疗耐药抑郁症 (TRD) 的症状持续改善. 这种组合可能会带来持久的好处,潜在地减少认知负担,并允许更宽的ECT间距.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 治疗耐药性抑郁症 (TRD) 带来了重大挑战,现有的疗法,如电疗法 (ECT) 和鼻内胺 (ESK),有时会产生残留症状或早期复发.
- 对于TRD,ECT和ESK的并发使用尚未得到充分证实,其潜在的持续益处仍然不清楚.
研究的目的:
- 描述电疗法 (ECT) 和鼻内乙胺 (ESK) 的联合使用在患有重症耐治疗抑郁症 (TRD) 的成年人中.
- 在24周的时间内评估这种联合治疗方法的可行性,有效性和安全性.
主要方法:
- 4名成年人 (50-72岁) 患有严重TRD的病例系列,他们从ECT或ESK单疗中获得了部分或逐渐减弱的益处.
- 在急性治疗期间,在非ECT的日子里,双边ECT (2-3次/周) 与ESK (28-84毫克,1-2剂/周) 结合.
- 电电疗法在24周内逐渐减少 (每1-3周),而ESK继续每周或每两周一次,根据反应和耐受性进行调整. 对症状严重程度 (MADRS),ECT节奏和不良事件进行了监测.
主要成果:
- 出现了两种反应概况:将ESK添加到ECT或相反导致部分反应患者的持续改善.
- 在维护ECT反应者中,添加ESK导致显著的症状减少 (MADRS减少50-83%) 并允许延长ECT间隔 (从每周到每14-21天).
- 整体平均症状减少率为58%,在24周内没有复发. 不良事件是轻微的和短暂的 (例如,短暂的解离,冲击后混乱),没有报告的严重事件.
结论:
- 结合ECT和ESK治疗对于严重的TRD似乎是可行的,表明持续的症状改善,并允许更广泛的ECT间隔.
- 与单一治疗相比,这种组合可能会提供潜在的较低的认知负担.
- 这些发现产生了假设,并支持了前性对照试验的需要,以优化结合ECT和ESK治疗的测序,剂量和安全协议.
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