Ketamine and magnesium common pathway of antidepressant action

Summary

Depression is a leading cause of disability, and many adults with major depression do not achieve remission with first-line treatments. Magnesium influences several neurotransmitter systems involved in emotional processes, including serotonergic, noradrenergic, dopaminergic, GABAergic, and glutamatergic systems. The mechanism of antidepressants' action involves the glutamatergic system, and magnesium ions may play a role in major depressive disorder pathophysiology by blocking the N-methyl-D-aspartate receptor (NMDAR). Ketamine, an NMDAR antagonist, has fast-acting antidepressant and antisuicidal effects. The evidence discussed suggests a possible synergistic interaction between magnesium and ketamine's pharmacodynamic activity in mood disorders.

Study at a glance

Abstract

Depression is one of the major causes of disability worldwide. A proportion of adults with major depression fail to achieve remission with first-line treatment. Magnesium influences the neurotransmission involved in emotional processes, such as the serotonergic, noradrenergic, dopaminergic, GABAergic and glutamatergic systems. It has been reported that the mechanism of antidepressants' action is involved in the glutamatergic system. Theories about the role of magnesium ions in pathophysiology of major depressive disorder include blocking the glutamatergic N-methyl-D-aspartate receptor (NMDAR). Ketamine, NMDAR antagonist, was found to promote fast-acting antidepressant and antisuicidal effects. Magnesium and ketamine seem to be involved in key mechanisms of the major depression pathophysiology. The evidence in the paper discussed may indicate the synergistic interaction between magnesium and ketamine pharmacodynamic activity being of particular importance in mood disorders.