Major depressive disorder (MDD) is a highly prevalent and disabling condition for which the currently available treatments are not fully effective. Existing unmet needs include rapid onset of action and optimal management of concurrent agitation. Dexmedetomidine (DEX) is a selective and potent α2-adrenergic receptor (α2-AR) agonist, with unique pharmacokinetic and pharmacodynamic properties. In this review, we discuss pre-clinical and clinical studies which focused on DEX in the context of its putative antidepressant effects for the management of MDD. Preliminary data support DEX as an antidepressant with fast onset of action, which would be especially helpful for patients experiencing treatment resistant depression, and agitation. We further explore the mechanistic and clinical implications of considering DEX as a putative antidepressant agent, and the next steps to explore the efficacy of low dose DEX infusion among patients with treatment resistant depression.

中文翻译：

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右美托咪定输注的潜在抗抑郁特性：机械、临床前和临床证据的回顾。

重度抑郁症 (MDD) 是一种高度流行和致残的疾病，目前可用的治疗方法并不完全有效。现有未满足的需求包括快速开始行动和对并发躁动的最佳管理。右旋美托咪（DEX）是一种选择性的和有效的α 2肾上腺素能受体（α2-AR) 激动剂，具有独特的药代动力学和药效学特性。在这篇综述中，我们讨论了临床前和临床研究，这些研究集中在 DEX 对 MDD 治疗的推定抗抑郁作用的背景下。初步数据支持 DEX 是一种起效快的抗抑郁药，这对经历治疗抵抗性抑郁和躁动的患者特别有帮助。我们进一步探讨了将 DEX 作为推定的抗抑郁药的机制和临床意义，以及下一步探索低剂量 DEX 输注对治疗抵抗性抑郁症患者的疗效的步骤。