Molecular psychiatry
September 1, 2024
Brandi Quintanilla, Carlos A Zarate, Anilkumar Pillai
17 citations
Over 300 million people worldwide have major depressive disorder (MDD), but only 30-40% achieve remission with standard antidepressants. Ketamine offers rapid relief within hours, unlike weeks for conventional drugs. While many studies focus on ketamine's effects on glutamate, this review highlights its anti-inflammatory actions, especially through the complement system—a part of innate immunity involved in synaptic plasticity. The complement system is linked to depression, with increased complement component 3 (C3) expression found in the prefrontal cortex of suicidal individuals with depression. Given ketamine's anti-inflammatory properties and the complement system's role in glutamate modulation, the review suggests a common link between the complement system and ketamine's mechanism of action.
Brain, behavior, and immunity
July 1, 2025
Brandi Quintanilla, Dede Greenstein, Ashutosh Tripathi et al.
7 citations
Ketamine, a rapid-acting antidepressant, may also regulate immune function. The complement system, part of the innate immune response involved in synaptic plasticity, has been linked to depression. This analysis of data from 39 people with major depressive disorder and 25 healthy volunteers, originally part of a randomized, double-blind trial comparing intravenous ketamine (0.5 mg/kg) to placebo, measured plasma levels of complement proteins C3a and C4a at baseline, 230 minutes, Day 1, and Day 3. A significant interaction between diagnosis and sex was found for C3a but not C4a levels. Ketamine's effects on C3a and C4a did not change over time. The findings suggest that targeting the complement pathway could lead to advances in treating major depressive disorder.
Translational psychiatry
November 18, 2025
Jenessa N Johnston, Peixiong Yuan, Bashkim Kadriu et al.
2 citations
In neurons derived from induced pluripotent stem cells of five women with treatment-resistant depression (average age 40.2 years), both the glycoprotein reelin and the ketamine metabolite (2R,6R)-hydroxynorketamine increased expression of several synaptic proteins (GluA1, PSD-95, Dab1, Synapsin I, and p-ERK) within one hour, with effects declining by 24 hours. Gene expression changes were similar for both compounds, though only reelin upregulated mTORC1 signaling. The findings suggest that iPSC-derived neurons may serve as a useful in vitro model for studying treatment-resistant depression and testing potential therapeutics.
Research square
February 12, 2026
Jenessa Johnston, Greg Jones, Shiyong Peng et al.
Rapid-acting antidepressants such as ketamine and psychedelics share common downstream effects on gene expression in human cortical neurons, despite targeting different initial receptors. Using stem cells from people with treatment-resistant depression and healthy volunteers, neurons were treated with several compounds. After 6 and 24 hours, gene activity was highly correlated across all drugs, converging on pathways related to inflammation, mTORC1 signaling, and cell growth. One compound, HNK, increased gene activity in excitatory neurons and decreased it in inhibitory neurons. These gene changes matched protein changes in spinal fluid from people given ketamine, supporting the model's relevance for studying antidepressant mechanisms.