Targeting inflammation in depression: Ketamine as an anti-inflammatory antidepressant in psychiatric emergency
Brain, Behavior, & Immunity - Health November 1, 2021 DOI: 10.1016/j.bbih.2021.100383 via Semantic Scholar
Summary
Ketamine, a dissociative anesthetic, produces rapid antidepressant effects at low doses, which may be partly due to its anti-inflammatory actions. This review examines ketamine's antidepressant properties and its influence on peripheral and central inflammation, aiming to clarify mechanisms that could make it a dual-action treatment for treatment-resistant depression (TRD) and suicidal ideation. Inflammation is linked to major depressive disorder (MDD) and poor treatment response, so medications that quickly address both inflammation and depressive symptoms could improve personalized care for psychiatric emergencies.
Study at a glance
| Characteristics | Review Peer reviewed |
|---|---|
| Keywords | Medicine |
| Citations | 67 |
| Key finding | Ketamine's rapid antidepressant effects may involve anti-inflammatory mechanisms, suggesting it as a potential dual-action therapy for inflammatory-induced treatment-resistant depression and suicidal behavior. |
Abstract
Major depressive disorder (MDD) is a common psychiatric disorder with multifactorial aetiology and complex pathophysiology. Despite availability of various pharmacological and non-pharmacological therapeutic strategies, treatment resistant depression (TRD) remains a significant challenge with specific concern for those patients with severe depressive symptoms in particular suicidal ideations who require immediate and effective intervention. Inflammation has been widely studied for its association with MDD and treatment response. Ketamine known as a dissociative anaesthetic has a novel rapid-acting antidepressant effect at lower doses. Anti-inflammatory actions of ketamine appear to play a role in mechanisms underlying its antidepressant effects. Considering the rapid antidepressant action of ketamine, this review provides a brief overview of antidepressant properties of ketamine as well as its effects on peripheral and central inflammation to better understand the mechanisms underlying the therapeutic action of ketamine as an anti-inflammatory antidepressant target in psychiatric emergency. Development of effective medications, which act rapidly with dual effect on both inflammation and MDD would be of a significant clinical importance for a successful and personalised treatment of inflammatory-induced TRD and suicidal thoughts and behaviour.