Potential molecular pathways and therapeutic implications of rapid-acting antidepressants on myelin biology: a scoping review.
Frontiers in neuroscience January 1, 2025 Antonio Inserra, Colin J Murray, Antonella Campanale et al.
Rapid-acting antidepressants, such as ketamine and serotonergic psychedelics, may affect myelin homeostasis. A systematic review of 41 studies (12 in humans, 21 in animals, 7 in vitro, and 1 computational) found that these drugs modulate myelination in a dose- and exposure-dependent manner: therapeutic doses generally promote myelin integrity and oligodendrocyte maturation, while high or repeated doses, or neonatal exposure, can disrupt myelin structure, impair oligodendrocyte viability, and produce cognitive, affective, and neurotoxic side effects. Myelin regulation may be a component of antidepressant action, but further research is needed to clarify mechanisms and implications for therapy.