Anesthetic drugs such as ketamine, nitrous oxide, propofol, and isoflurane show rapid and sustained antidepressant properties, positioning anesthesiologists at a new frontier in treating neuropsychiatric disorders. This article reviews these drugs as novel antidepressants and identifies future candidates for depression treatment. The authors call for collaboration between anesthesiologists and psychiatrists to repurpose anesthetic drugs as antidepressants and address mood disorders in surgical patients.
Postoperative delirium and other cognitive problems are common in older surgical patients. Ketamine, given before or during anesthesia, might protect cognition by reducing inflammation or allowing lower doses of other drugs, but its effectiveness is debated. This review of 58 studies involving 6830 patients found that ketamine provided no cognitive benefit in 60% of studies, while 40% reported reduced incidence or duration of cognitive disorders. No clear patterns emerged for dose, formulation, or timing. Studies assessing cognition only early after surgery were more likely to show no benefit. Most trials were too small and methods too varied for meta-analysis. The inconsistent results support the need for larger, well-designed trials to identify which patient subgroups might benefit.