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How ketamine works: An actionable hypothesis.

Roberto Malinow

Proceedings of the National Academy of Sciences of the United States of America May 5, 2026 Peer reviewed DOI: 10.1073/pnas.2533728123 via PubMed

Summary

Ketamine reduces depression and suicidality in individuals who do not respond to other treatments. The exact mechanism of action is unclear, but a new hypothesis suggests that it may involve synaptic and circuit plasticity, potentially improving treatment efficacy for depression and other conditions.

Study at a glance

Population individuals resistant to treatment by other drugs
Key finding Ketamine has been shown to reduce depression and suicidality in individuals resistant to treatment by other drugs.

Abstract

Ketamine has been shown to reduce depression and suicidality in individuals resistant to treatment by other drugs. Exactly how ketamine works is not known. Here, I propose a new hypothesis that involves synaptic and circuit plasticity and may lead to enhanced efficacy in treating depression as well as other conditions.

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