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Depression and antidepressant effects of ketamine and its metabolites: The pivotal role of gut microbiota.

Hao-Ming Hua, Chao Huang, Hanyu Liu, Xiangyang Xu, Xiangqing Xu, Zifeng Wu, Cunming Liu, Yuanyuan Wang, Chun Yang

Neuropharmacology September 1, 2022 DOI: 10.1016/j.neuropharm.2022.109272 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Review Peer reviewed
Topics Depression Esketamine Ketamine
Citations 35
Key findings Ketamine's antidepressant mechanisms may involve bidirectional regulation via the microbiota-gut-brain axis, including stress response, BDNF-mediated neurogenesis, anti-inflammatory effects, and neurotransmitter modulation.

Abstract

The discovery of the robust antidepressant actions of ketamine is regarded as one of the greatest advancements in depression treatment in the past 60 years. Recent findings have provided strong evidence for the presence of bidirectional communication networks between the gastrointestinal tract and the brain in depression. Moreover, increasing evidence supports the antidepressant role of ketamine in regulating the gut microbiome and microbiota-derived molecules; however, the mechanisms underpinning such effects are still ambiguous. This review summarizes the current understanding of the anti-depressant mechanisms of ketamine and its metabolites regarding the bidirectional regulation by microbiota-gut-brain axis. We review the relationship between gut microbiota and the antidepressant mechanisms of ketamine, and discuss the role of stress response, brain-derived neurotrophic factor (BDNF)-mediated neurogenesis, anti-inflammatory effect and neurotransmitters.