Ketamine, Esketamine, and Arketamine: Their Mechanisms of Action and Applications in the Treatment of Depression and Alleviation of Depressive Symptoms.
Biomedicines October 9, 2024 Piotr Kawczak, Igor Feszak, Tomasz Bączek 50 citations
Esketamine, the (S)-enantiomer of ketamine, is more potent than arketamine, offering three times stronger analgesic effects and 1.5 times greater anesthetic efficacy. It provides smoother anesthesia with fewer side effects and is used clinically for its neuroprotective, bronchodilatory, and antiepileptic properties. Approved by the FDA and EMA in 2019, esketamine is prescribed alongside SSRIs or SNRIs for treatment-resistant depression. Arketamine, the (R)-enantiomer, shows potential for treating neurological disorders like Alzheimer's, Parkinson's, and multiple sclerosis, with possible antidepressant and anti-inflammatory benefits. Esketamine is already in clinical use, while arketamine requires further research on safety, efficacy, and dosing.