Bridging rapid and sustained antidepressant effects of ketamine

Trends Mol Med. 2023 May;29(5):364-375. doi: 10.1016/j.molmed.2023.02.003. Epub 2023 Mar 10.

Abstract

Acute administration of (R,S)-ketamine (ketamine) produces rapid antidepressant effects that in some patients can be sustained for several days to more than a week. Ketamine blocks N-methyl-d-asparate (NMDA) receptors (NMDARs) to elicit specific downstream signaling that induces a novel form of synaptic plasticity in the hippocampus that has been linked to the rapid antidepressant action. These signaling events lead to subsequent downstream transcriptional changes that are involved in the sustained antidepressant effects. Here we review how ketamine triggers this intracellular signaling pathway to mediate synaptic plasticity which underlies the rapid antidepressant effects and links it to downstream signaling and the sustained antidepressant effects.

Keywords: BDNF; antidepressant; intracellular signaling; ketamine; synaptic plasticity.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Antidepressive Agents / metabolism
  • Antidepressive Agents / pharmacology
  • Antidepressive Agents / therapeutic use
  • Depression / drug therapy
  • Hippocampus
  • Humans
  • Ketamine* / metabolism
  • Ketamine* / pharmacology
  • Ketamine* / therapeutic use
  • Signal Transduction

Substances

  • Ketamine
  • Antidepressive Agents