Ketamine and the next generation of antidepressants with a rapid onset of action

Summary & key facts

This paper reviews research showing that low doses of ketamine can lift depressive symptoms much faster than standard antidepressants. In some people who did not get better with other treatments, a single intravenous dose brought mood improvements within hours. The benefits often fade after days to a week, and scientists say more work is needed to understand safety, how to keep the effect longer, and how to build new fast-acting medicines based on ketamine’s brain effects.

Key facts:

• Several clinical studies found that a single low-dose intravenous ketamine infusion eased depressive symptoms within hours in people who had not responded to other antidepressants.
• For many patients, the mood improvement after one ketamine dose lasts for days to about a week, but the effect usually does not last long without more treatment.
• Ketamine works differently from standard antidepressants. It blocks a specific brain receptor that senses the chemical glutamate. That change seems to trigger a burst of glutamate activity and then quick-building of new connections between brain cells.
• Animal and lab studies point to a cell pathway called mTOR that helps make new synapses (connections). Activation of this pathway after ketamine may help explain the rapid mood change seen in people.
• Ketamine can cause short-term side effects such as feeling detached from your body or surroundings, odd perceptions, and rises in blood pressure. Long-term safety and the best treatment schedules are not yet known.
• Researchers view ketamine as proof that it is possible to make antidepressants that work quickly. But they also say we need safer drugs and more studies before using ketamine widely as a long-term treatment.

Topics

Neuroscience and Neuropharmacology Research Treatment of Major Depression Tryptophan and brain disorders

Categories

Health Sciences Medicine Pharmacology

Tags

Antidepressant Anxiety Biology Cognition Context (archaeology) Ketamine Major depressive disorder Medicine Neuroscience Paleontology Pharmacology Psychiatry Psychology

Substances

Ketamine

Conditions & symptoms

Anxiety Depression Lack of energy or motivation Sadness or low mood