Neuropharmacology
October 1, 2022
Kai Zhang, Yitan Yao, K. Hashimoto
68 citations
Ketamine can rapidly relieve depressive symptoms within hours of a single dose, even in patients who do not respond to traditional antidepressants, which often take weeks to work. However, the specific mechanisms behind this rapid effect are not fully understood, and ketamine is associated with serious side effects like dissociative symptoms, cognitive impairment, and abuse potential. This review examines ketamine's pharmacological properties and proposed mechanisms of action, including the disinhibition hypothesis, synaptogenesis, and downstream pathways such as enhanced brain-derived neurotrophic factor signaling and activation of mechanistic target of rapamycin complex 1. (R)-ketamine may offer a safer alternative with fewer adverse effects, and understanding these mechanisms could help develop new rapid antidepressants that maximize benefits while minimizing risks.
European archives of psychiatry and clinical neuroscience
September 28, 2024
Yue Wang, Qiongyao Yang, Chuanchuan Chen et al.
10 citations
After six low-dose esketamine infusions, patients with treatment-resistant depression showed improvement in anhedonia and depressive symptoms. Plasma levels of cortisol, interleukin-6, and tumor necrosis factor-alpha decreased, while the anti-inflammatory cytokine interleukin-4 increased. Baseline cortisol levels correlated with anhedonia, but inflammatory factors showed no significant correlation. Elevated plasma cortisol may serve as a potential biomarker for anhedonia in treatment-resistant depression.
Journal of affective disorders
January 15, 2025
Qiongyao Yang, Yitan Yao, Xiaoping Yuan et al.
3 citations
In patients with depression, six intravenous infusions of esketamine (0.4 mg/kg) over 11 days significantly reduced depressive symptoms, with mean Montgomery-Asberg Depression Rating Scale scores dropping from 32.11 to 15.10. Memory function—including immediate memory, language, attention, and delayed memory—improved, and plasma nerve growth factor (NGF) levels rose from 226.13 to 384.37 pg/mL. A positive correlation existed between baseline memory function and NGF levels, while higher baseline memory was linked to smaller NGF increases. These findings suggest NGF may contribute to esketamine's memory-enhancing effects, though the open-label design limits certainty.