Assuntos
Antidepressivos/uso terapêutico , Antimaníacos/uso terapêutico , Transtorno Bipolar/tratamento farmacológico , Transtorno Depressivo/tratamento farmacológico , Ketamina/uso terapêutico , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Pesquisas sobre Atenção à Saúde , Humanos , Uso Off-Label , Resultado do TratamentoRESUMO
IMPORTANCE: Several studies now provide evidence of ketamine hydrochloride's ability to produce rapid and robust antidepressant effects in patients with mood and anxiety disorders that were previously resistant to treatment. Despite the relatively small sample sizes, lack of longer-term data on efficacy, and limited data on safety provided by these studies, they have led to increased use of ketamine as an off-label treatment for mood and other psychiatric disorders. OBSERVATIONS: This review and consensus statement provides a general overview of the data on the use of ketamine for the treatment of mood disorders and highlights the limitations of the existing knowledge. While ketamine may be beneficial to some patients with mood disorders, it is important to consider the limitations of the available data and the potential risk associated with the drug when considering the treatment option. CONCLUSIONS AND RELEVANCE: The suggestions provided are intended to facilitate clinical decision making and encourage an evidence-based approach to using ketamine in the treatment of psychiatric disorders considering the limited information that is currently available. This article provides information on potentially important issues related to the off-label treatment approach that should be considered to help ensure patient safety.
Assuntos
Transtornos de Ansiedade/tratamento farmacológico , Transtorno Depressivo Resistente a Tratamento/tratamento farmacológico , Ketamina/uso terapêutico , Transtornos do Humor/tratamento farmacológico , Uso Off-Label , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Transtorno Depressivo Resistente a Tratamento/diagnóstico , Transtorno Depressivo Resistente a Tratamento/psicologia , Relação Dose-Resposta a Droga , Medicina Baseada em Evidências , Humanos , Infusões Intravenosas , Ketamina/efeitos adversos , Transtornos do Humor/diagnóstico , Transtornos do Humor/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Resultado do TratamentoAssuntos
Antidepressivos/efeitos adversos , Antidepressivos/uso terapêutico , Transtorno Bipolar/tratamento farmacológico , Ketamina/efeitos adversos , Ketamina/uso terapêutico , Administração Intravenosa , Adulto , Afeto/efeitos dos fármacos , Antidepressivos/administração & dosagem , Transtorno Bipolar/complicações , Feminino , Humanos , Ketamina/administração & dosagem , Entrevista Psiquiátrica Padronizada , Resultado do TratamentoRESUMO
Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice.
