Overlap in the neural circuitry and molecular mechanisms underlying ketamine abuse and its use as an antidepressant.
Behavioural Brain Research February 13, 2020 S. Kokane, Ross J. Armant, Carlos A. Bolaños-Guzmán et al.
Ketamine shows rapid antidepressant effects in major depressive disorder, suicidal tendencies, and treatment-resistant depression, but these effects are transient and require repeated clinic visits. Repeated exposure raises concern because ketamine has abuse liability, and depression and addiction share overlapping neural circuitry and molecular mechanisms. The review outlines limited knowledge of ketamine's neurobiological underpinnings mediating antidepressant effects and correlates them to its abuse potential. Although speculative, repeated ketamine use for depression could lead to substance use disorder, warranting caution. The lack of understanding of long-term effects and mechanisms is a limiting factor that needs systematic investigation before repeated use in depressed patients.