Intravenous infusion of
lanicemine (formerly
AZD6765), a low trapping non-selective
N-methyl-D-aspartate (
NMDA) receptor antagonist, induces
antidepressant effects with a similar time course to
ketamine. We investigated whether a single dose
lanicemine infusion would reproduce the previously reported decrease in subgenual anterior cingulate cortex (sgACC) activity evoked by
ketamine, a potential mechanism of
antidepressant efficacy. Sixty un-medicated adults meeting the criteria for
major depressive disorder were randomly assigned to receive constant
intravenous infusions of
ketamine,
lanicemine or saline during a 60min pharmacological magnetic resonance imaging (phMRI) scan. Both
ketamine and
lanicemine gradually increased the blood oxygen level dependent signal in sgACC and rostral ACC as the primary outcome measure. No decreases in signal were seen in any region. Interviewer-rated psychotic and dissociative symptoms were minimal following administration of
lanicemine. There was no significant
antidepressant effect of either infusion compared to saline. The previously reported deactivation of sgACC after
ketamine probably reflects the rapid and pronounced subjective effects evoked by the bolus-infusion method used in the previous study. Activation of the ACC was observed following two different
NMDA compounds in both Manchester and Oxford using different 3T MRI scanners, and this effect predicted improvement in mood 1 and 7 days post-infusion. These findings suggest that the initial site of
antidepressant action for
NMDA antagonists may be the ACC (NCT01046630. A Phase I, Multi-centre, Double-blind, Placebo-controlled Parallel Group Study to Assess the pharmacoMRI Effects of
AZD6765 in Male and Female Subjects Fulfilling the Criteria for
Major Depressive Disorder; http://clinicaltrials.gov/show/NCT01046630).