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Anesthetics as Treatments for Depression: Clinical Insights and Underlying Mechanisms.

Macauley Smith Breault, Sirma Orguc, Ohyoon Kwon, Gloria H Kang, Bryan Tseng, David R Schreier, Emery N Brown

Annual review of neuroscience February 19, 2025 DOI: 10.1146/annurev-neuro-112723-062031 via PubMed

Summary

AI-generated from the abstract

Several anesthetic agents beyond ketamine show antidepressant effects, including nitrous oxide, propofol, isoflurane, sevoflurane, dexmedetomidine, and xenon. This review examines clinical and basic science studies on these anesthetics for treating depression. The authors propose that anesthetics may alleviate depression by modulating brain dynamics that alter arousal states, linking anesthetic mechanisms to depression pathophysiology and findings from other treatments. The work suggests that repurposing anesthetics could offer new options for major depressive disorder and treatment-resistant depression.

Study at a glance

Characteristics Review Peer reviewed
Keywords Depression treatment Anesthesia research Mental health breakthroughs Drug repurposing
Citations 13
Key finding Several anesthetics besides ketamine demonstrate antidepressant effects, potentially through modulation of brain dynamics and arousal states.

Abstract

Major depressive disorder and treatment-resistant depression are significant worldwide health problems that need new therapies. The success of the anesthetic ketamine as an antidepressant is well known. It is less widely known that several other anesthetic agents have also shown antidepressant effects. These include nitrous oxide, propofol, isoflurane, sevoflurane, dexmedetomidine, and xenon. We review clinical and basic science investigations that have studied the therapeutic value of these anesthetics for treating depression. We propose potential neurophysiological mechanisms underlying the antidepressant effects of anesthetics by combining our understanding of how anesthetics modulate brain dynamics to alter arousal states, current theories of depression pathophysiology, and findings from other depression treatment modalities.

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