A 26-year-old man who abused ketamine by inhalation for 12 months developed manic-like symptoms after using the drug. This case suggests a possible relationship between manic symptoms and ketamine abuse, and may be the first report of mania following recreational ketamine use.
A review compares the antidepressant mechanisms of sarcosine, benzoate, ketamine, esketamine, and arketamine. These compounds modulate N-methyl-d-aspartate glutamate receptors (NMDARs) and reduce brain inflammation by inhibiting microglial activity. Though they act differently as antagonists or coagonists of NMDARs, all have shown efficacy in animal models or human trials. The review concludes that these drugs act as both NMDAR modulators and anti-inflammatory agents, making them potentially effective for treating depression.