Beyond surgery: Repurposing anesthetics for treatment of central nervous system disorders.

Drug repurposing—finding new uses for existing medications—offers a faster, cheaper alternative to traditional drug development, especially for neurological and psychiatric disorders. This narrative review examines preclinical and clinical studies on anesthetics including ketamine, nitrous oxide, isoflurane, sevoflurane, propofol, dexmedetomidine, and sodium oxybate for treating central nervous system disorders. Anesthetics show potential for rapid antidepressant effects, enhanced learning and memory, improved synaptic plasticity, and neuroprotection, suggesting promise for depression, post-traumatic stress disorder, cognitive decline, traumatic brain injury, and neurodegenerative disorders. These effects likely involve modulation of GABAergic and glutamatergic pathways. Challenges include dose-dependent neurotoxicity, variability in outcomes, and environmental concerns. Further research is needed to optimize dosing, ensure long-term safety, and clarify mechanisms.

Study at a glance

Abstract

The development of new drugs is a complex, expensive, and time-consuming process, often fraught with a high likelihood of failure. Amid these obstacles, drug repurposing, which identifies new therapeutic applications for already existing medications, offers a more economical and time-saving approach, particularly in the challenging field of neurological and psychiatric disorders. This narrative review explores both preclinical and clinical studies to examine the potential of anesthetics such as ketamine, nitrous oxide, isoflurane, sevoflurane, propofol, dexmedetomidine, and sodium oxybate in treating central nervous system disorders. Various research highlights the potential of anesthetics to provide rapid antidepressant effects, enhance learning and memory, improve synaptic plasticity, and offer neuroprotective benefits, demonstrating promise for treating depression, post-traumatic stress disorder, cognitive decline, traumatic brain injury, and neurodegenerative disorders. Anesthetics appear to alleviate symptoms in neurological conditions, likely by modulating GABAergic and glutamatergic pathways. However, challenges such as dose-dependent neurotoxicity, variability in preclinical and clinical outcomes, as well as environmental concerns remain significant issues. Future research is essential to optimize dosing strategies, ensure long-term safety, and gain a deeper understanding of the precise mechanisms of action. The concept of anesthetics' repurposing presents a unique solution to tackle the challenges in neurological and psychiatric therapy by providing a platform for the development of new and improved therapies.