The emerging roles of ketamine and esketamine as effective rapid-acting antidepressants hold promise for patients suffering from treatment-resistant depression and/or major depressive disorder with suicidality. Practitioner familiarity with common tolerability/safety concerns along with pragmatic prevention and management strategies are needed to reduce patient burden and improve the acceptability and accessibility of these treatments. The most common treatment-emergent adverse events associated with ketamine/esketamine are dissociation, anxiety, nausea, increased blood pressure, and headache. The majority of side effects are mild, transient, dose dependent, and attenuate with subsequent treatments. Patient selection, baseline physical and psychiatric assessments, and an appropriate setting are critical first steps in the prevention and mitigation of adverse events. Patient education and supportive interventions play central roles in the prevention and management of select adverse events. Severe and/or clinically significant adverse effects may necessitate the judicious use of adjunctive medications. Moreover, practitioners must remain vigilant to the potential for abuse liability and long-term adverse events, for which there are insufficient data. This article succinctly reviews common treatment-emergent adverse events of ketamine and esketamine within the context of mood disorders, and provides practical suggestions for prevention and management at point-of-care.

氯胺酮和艾氯胺酮作为有效的速效抗抑郁药的新兴作用为患有难治性抑郁症和/或有自杀倾向的重度抑郁症的患者带来了希望。从业者需要熟悉常见的耐受性/安全问题以及务实的预防和管理策略，以减轻患者负担并提高这些治疗的可接受性和可及性。与氯胺酮/艾氯胺酮相关的最常见的治疗出现的不良事件是解离、焦虑、恶心、血压升高和头痛。大多数副作用是轻微的、短暂的、剂量依赖性的，并随着后续治疗而减弱。患者选择，基线身体和精神评估，适当的环境是预防和减轻不良事件的关键第一步。患者教育和支持性干预在特定不良事件的预防和管理中发挥着核心作用。严重和/或临床上显着的不良反应可能需要明智地使用辅助药物。此外，从业人员必须对滥用责任和长期不良事件的可能性保持警惕，因为数据不足。本文简要回顾了氯胺酮和艾氯胺酮在情绪障碍背景下的常见治疗出现的不良事件，并为床旁的预防和管理提供了实用的建议。严重和/或临床上显着的不良反应可能需要明智地使用辅助药物。此外，从业人员必须对滥用责任和长期不良事件的可能性保持警惕，因为数据不足。本文简要回顾了氯胺酮和艾氯胺酮在情绪障碍背景下的常见治疗出现的不良事件，并为床旁的预防和管理提供了实用的建议。严重和/或临床上显着的不良反应可能需要明智地使用辅助药物。此外，从业人员必须对滥用责任和长期不良事件的可能性保持警惕，因为数据不足。本文简要回顾了氯胺酮和艾氯胺酮在情绪障碍背景下的常见治疗出现的不良事件，并为床旁的预防和管理提供了实用的建议。