Kynurenine pathway metabolism and the neurobiology of treatment-resistant depression: Comparison of multiple ketamine infusions and electroconvulsive therapy.
Journal of Psychiatric Research February 10, 2018 Andrew P. Allen, Maura Naughton, J. Dowling et al. 53 citations
Current first-line antidepressants often take weeks to improve symptoms, but low-dose ketamine may work faster, even in treatment-resistant depression. This study compared the effects of ketamine infusion and electroconvulsive therapy (ECT) on biological markers related to stress and inflammation in patients with treatment-resistant depression versus healthy controls. Both treatments improved depressive symptoms. At baseline, patients showed differences in cortisol and kynurenine pathway metabolites compared to controls, though inflammatory markers were similar. After ECT, the cortisol awakening response decreased in responders. Ketamine showed a trend toward reduced kynurenine in responders but did not significantly alter any measured biomarkers.