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Ketamine’s antidepressant action: beyond NMDA receptor inhibition

Kenji Hashimoto

Expert Opinion on Therapeutic Targets September 20, 2016 DOI: 10.1080/14728222.2016.1238899 via OpenAlex

Summary

The NMDA receptor antagonist ketamine produces rapid and lasting antidepressant effects in people with treatment-resistant depression, but how it does so is not fully understood. A key metabolite of (R)-ketamine, called (2R,6R)-hydroxynorketamine (HNK), shows antidepressant effects in rodent models of depression. This suggests that the conversion of (R)-ketamine into (2R,6R)-HNK is crucial for its antidepressant action. The article discusses these findings and their broader significance.

Study at a glance

Characteristics Review Peer reviewed
Topics Ketamine
Keywords Antidepressant Nmda receptor Pharmacology Context archaeology
Citations 68
Key finding The conversion of (R)-ketamine to its metabolite (2R,6R)-HNK is pivotal for its antidepressant action in rodent models.

Abstract

The N-methyl-D-aspartate (NMDA) receptor antagonist ketamine is one of the most attractive antidepressants since this drug causes rapid-onset and sustained antidepressant effects in treatment resistant patients with depression. There are unanswered questions about how ketamine induces its rapid and sustained antidepressant actions. This key article suggests that (2R,6R)-HNK (hydroxynorketamine), a major metabolite of (R)-ketamine, shows antidepressant effects in rodent models of depression, indicating that the metabolism of (R)-ketamine to (2R,6R)-HNK is pivotal in its antidepressant action. Here these findings are put into context and their significance is discussed.

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