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Ketamine and rapid-acting antidepressants: a window into a new neurobiology for mood disorder therapeutics.

Abstract
Ketamine is the prototype for a new generation of glutamate-based antidepressants that rapidly alleviate depression within hours of treatment. Over the past decade, there has been replicated evidence demonstrating the rapid and potent antidepressant effects of ketamine in treatment-resistant depression. Moreover, preclinical and biomarker studies have begun to elucidate the mechanism underlying the rapid antidepressant effects of ketamine, offering a new window into the biology of depression and identifying a plethora of potential treatment targets. This article discusses the efficacy, safety, and tolerability of ketamine, summarizes the neurobiology of depression, reviews the mechanisms underlying the rapid antidepressant effects of ketamine, and discusses the prospects for next-generation rapid-acting antidepressants.
AuthorsChadi G Abdallah, Gerard Sanacora, Ronald S Duman, John H Krystal
JournalAnnual review of medicine (Annu Rev Med) Vol. 66 Pg. 509-23 ( 2015) ISSN: 1545-326X [Electronic] United States
PMID25341010 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Review)
Chemical References
  • Antidepressive Agents
  • Excitatory Amino Acid Antagonists
  • Glutamic Acid
  • Ketamine
Topics
  • Antidepressive Agents (therapeutic use)
  • Brain (metabolism)
  • Depressive Disorder, Major (drug therapy, metabolism)
  • Depressive Disorder, Treatment-Resistant (drug therapy, metabolism)
  • Excitatory Amino Acid Antagonists (therapeutic use)
  • Glutamic Acid (metabolism)
  • Humans
  • Ketamine (therapeutic use)
  • Mood Disorders (drug therapy, metabolism)
  • Neuronal Plasticity
  • Prefrontal Cortex (metabolism)

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