Understanding the variability in ketamine’s efficacy in managing treatment-resistant depression
Discover Psychology November 3, 2024 DOI: 10.1007/s44202-024-00277-5 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Intervention | Ketamine |
| Topics | Depression Ketamine Neuroplasticity Esketamine |
| Citations | 3 |
| Key findings | Ketamine treats depression by antagonizing NMDA receptors, increasing glutamate, and promoting neuroplasticity, but individual response varies, necessitating tailored approaches. |
Abstract
Abstract Ketamine, often associated with its frequent illicit recreational use, is renowned as an approved alternative for treatment-resistant depression. This paper evaluates the mechanism of ketamine’s role in treating depression, emphasising its positive safety profile and acute onset of action. Ketamine’s mechanism of action involves antagonism of N-methyl-D-Aspartate (NMDA) receptors, leading to increased glutamate production in brain regions associated with mood regulation. Moreover, ketamine counteracts the effects of chronic stress by promoting synaptic plasticity and neurogenesis. However, the response to ketamine varies among individuals, prompting the need for further investigation into the factors influencing its efficacy, such as route of administration, dose and the rate at which it is delivered. Other variables such as past traumatic experiences and genetic predispositions may also play a significant role in determining an individual’s response to ketamine therapy, raising the importance of tailored treatment approaches. Furthermore, there is growing interest in investigating the synergy of ketamine alongside other therapeutic modalities, including Cognitive Behavioural Therapy (CBT) and Mindfulness-Based Interventions (MBIs), as a means to enhance treatment outcomes in modern psychiatry.
Comparable studies
Other narrative reviews on ketamine for depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation Adults with treatment-resistant depression | 2021 | Review | |
| Ketamine: a paradigm shift for depression research and treatment | 2019 | Review | |
| Rapid‐acting antidepressant ketamine, its metabolites and other candidates: A historical overview and future perspective | 2019 | Review | |
| Ketamine: A tale of two enantiomers | 2020 | Review | |
| Molecular mechanisms underlying the antidepressant actions of arketamine: beyond the NMDA receptor | 2021 | Review |
Citations in the library
Cites 45
- mTOR-Dependent Synapse Formation Underlies the Rapid Antidepressant Effects of NMDA Antagonists Science August 19, 2010
- Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry May 17, 2016
- Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms Pharmacological Reviews June 26, 2018
- Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression JAMA Psychiatry December 27, 2017
- The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis American Journal of Psychiatry October 3, 2017
and 40 more in the library