Effects and mechanisms of esketamine on depression by targeting gut microbiota: A narrative review
Jia-Qi Liu, Chen Zhou
New Discovery April 30, 2025 DOI: 10.61958/ndfs6517 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Depression Esketamine |
| Key findings | Esketamine exhibits a therapeutic effect against depression by modulating the gut microbiota and its metabolites. |
Abstract
Depression is a severe and recurrent neuropsychiatric disease with high prevalence, disability, and mortality, which imposes a heavy burden on national public health and the economy. Traditional antidepressants demonstrate delayed effects, low cure rates, and inadequate therapeutic effectiveness for managing treatment-resistant depression. Numerous studies have proved that esketamine, a non-competitive N-methyl-D-aspartate receptor antagonist, can produce a rapid and sustained antidepressant effect, which was approved by the FDA and EMA in 2019 and 2020, respectively. However, the pharmacological mechanism underlying the antidepressant effects of esketamine remains inadequately understood. Previous studies have shown that gut microbiota plays a significant role in central nervous system regulation such as emotional behavior and cognitive function. Moreover, fecal microbiota transplantation can alleviate depression by regulating the disorder of gut microbiota. Notably, esketamine exhibited a therapeutic effect against depression by modulating the gut microbiota and its metabolites. Therefore, this review summarized the current research progress on the functional role and mechanism of esketamine in the treatment of depression, as well as discussed the pharmacological mechanism for esketamine’s antidepressant effects by regulating gut microbiota.
Comparable studies
Other narrative reviews on esketamine 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 | |
| Long-term safety of ketamine and esketamine in treatment of depression | 2022 | Review | |
| Ketamine, Esketamine, and Arketamine: Their Mechanisms of Action and Applications in the Treatment of Depression and Alleviation of Depressive Symptoms. | 2024 | Review | |
| Variations in BDNF and Their Role in the Neurotrophic Antidepressant Mechanisms of Ketamine and Esketamine: A Review. Patients with depression | 2024 | Narrative review | |
| The Possible Application of Ketamine in the Treatment of Depression in Alzheimer’s Disease | 2022 | Review |