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The dynamics of AMPA receptors underlies the efficacy of ketamine in treatment resistant patients with depression

Waki Nakajima, Mai Hatano, Yohei Ohtani, Hideaki Tani, Taisuke Yatomi, Shohei Tsuchimoto, Yu Fujimoto, Tsuyoshi Eiro, Sadamitsu Ichijo, Kotaro Nakano, Tetsu Arisawa, Yuuki Takada, Kimito Kimura, Hiroki Abe, Akane Sano, Kie Nomoto-Takahashi, Kengo Yonezawa, Sota Tomiyama, Nobuhiro Nagai, Keisuke Kusudo, Shiori Honda, Sotaro Moriyama, Shinichiro Nakajima, Takashige Yamada, Yu Iwabuchi, Masahiro Jinzaki, Kimio Yoshimura, Shariful A. Syed, Sakiko Tsugawa, Hiroyuki Uchida, Takuya Takahashi

Molecular Psychiatry March 5, 2026 DOI: 10.1038/s41380-026-03510-w (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Observational cohort with intervention Peer reviewed
Population Patients with treatment-resistant depression and healthy participants
Intervention Ketamine
Topics Depression Esketamine Ketamine
Citations 1
Key findings AMPAR density changes in specific brain areas correlate with ketamine's antidepressant effect in treatment-resistant depression.

Abstract

Approximately 30% of patients with depression suffer from treatment-resistant depression (TRD). Ketamine has shown antidepressant efficacy for TRD. While glutamate α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) has been demonstrated to play crucial roles in the process of pharmacological action of ketamine in experimental animals, it remains elusive how ketamine exhibits its efficacy through changes in AMPAR dynamics in patients with TRD. In this study, using a positron emission tomography (PET) tracer, [11C]K-2, which depicts AMPAR density in the living human brain, we detected a negative correlation between AMPAR density and illness severity and differences in AMPAR distribution between patients with TRD and healthy participants. Furthermore, we detected brain areas where ketamine administration altered AMPAR density in significant correlations with ketamine-induced antidepressant effect in patients with TRD. AMPAR density alteration in these regions partially rescued AMPAR phenotype in the affected areas. Thus, AMPAR dynamics underlies the antidepressant effect of ketamine in patients with TRD.

Comparable studies

Other observational and cohort studies on ketamine for depression, most cited first.

Study Year Design Participants
Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder Patients with treatment-resistant major depressive disorder 2012 Observational cohort n = 30
Altered peripheral immune profiles in treatment-resistant depression: response to ketamine and prediction of treatment outcome Healthy controls and actively depressed patients with treatment-resistant depression... 2017 Observational cohort n = 59
Clinical Predictors of Ketamine Response in Treatment-Resistant Major Depression Treatment-resistant inpatients with DSM-IV-TR-diagnosed major depressive disorder or... 2014 Post hoc analysis of pooled data from four studies n = 108
An investigation of amino-acid neurotransmitters as potential predictors of clinical improvement to ketamine in depression Drug-free patients with major depressive disorder 2011 Observational cohort n = 14
Efficacy of ketamine therapy in the treatment of depression Drug-free/naïve men with severe depression, no history of psychotic disorder, head... 2019 Observational cohort n = 25

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