Ketamine and its two enantiomers in anesthesiology and psychiatry: A historical review and future directions
Journal of Anesthesia and Translational Medicine July 11, 2024 Kenji Hashimoto, Mingming Zhao, Tingting Zhu et al. 32 citations
Ketamine and its enantiomers have a long history in anesthesia and are now gaining attention for rapid-acting antidepressant effects in severe depression. Esketamine, the (S)-enantiomer, received approval in the U.S. and Europe in 2019 as a nasal spray for depression, but concerns about long-term efficacy, addiction, and suicide risk persist. In rodent models, arketamine, the (R)-enantiomer, shows superior and longer-lasting antidepressant effects with fewer side effects than esketamine, though human research on arketamine is limited. The article reviews the historical use of ketamine and its enantiomers in anesthesia and psychiatry and explores future directions.