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Ascorbic acid enhances antidepressant-like efficacy of esketamine: Hippocampal TARP-γ8-containing AMPA receptors mediate synaptic modulation.

Zhaojuan Ke, Ying Zhang, Xin Jiang, Jie Luo, Hengsheng Chen, Yao Ma, Qibin Chen, Li Zhao, Binyang Cai

Neurotherapeutics November 11, 2025 DOI: 10.1016/j.neurot.2025.e00786 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Preclinical animal study Peer reviewed
Population Chronic restraint stress-induced mouse model of depression
Interventions Ascorbic acid Esketamine
Topics Depression Ketamine Esketamine
Keywords Hippocampus Synapses Animals Mice, inbred c57bl Ascorbic acid Calcium channels Receptors, ampa Antidepressive agents Drug therapy, combination Neuronal plasticity Drug synergism Male Ampa receptor
Key points Ascorbic acid enhanced a subeffective dose of esketamine, fully reversing behavioral and synaptic deficits in depressed mice to levels comparable with healthy controls, equivalent to an effective esketamine dose alone. Blocking hippocampal TARP-γ8-containing AMPA receptors abolished this combined antidepressant-like effect, indicating these receptors are required for the enhancement.

Abstract

Ketamine exhibits superior efficacy compared to conventional antidepressants, yet its clinical application remains limited by dose-dependent side effects. Ascorbic acid (AA) augments ketamine's antidepressant-like effects, suggesting that AA co-administration with subtherapeutic ketamine doses may achieve optimal efficacy while improving safety. Since AA itself lacks independently clinical antidepressant efficacy, its enhancement on the efficacy of ketamine raises a mechanistic question. This study investigated the antidepressant-like effects of AA combined with esketamine (ketamine's S-enantiomer) and elucidated the role of hippocampal TARP-γ8-containing AMPA receptors (AMPARs) in this enhancement. We employed a chronic restraint stress-induced mouse model of depression to evaluate depressive-like behaviors, hippocampal synaptic markers, and neural plasticity. The effects of AA, esketamine, and their combination were examined, along with pharmacological modulation of hippocampal TARP-γ8-containing AMPARs. Our findings demonstrated that AA enhanced the action of a subeffective dose of esketamine, fully reversing both behavioral and synaptic deficits in depressed mice to levels comparable with healthy controls. This combinatorial effect was equivalent to that achieved by an effective dose of esketamine alone. Selective pharmacological blockade of hippocampal TARP-γ8-containing AMPARs completely abolished the antidepressant-like efficacy of the subeffective-dosed AA-esketamine combination. However, the same blockade did not affect baseline depressive-like phenotypes in depressed mice or the inactivity of either agent at subeffective dose alone. These results indicate that AA's enhancement of esketamine's antidepressant-like effects requires the dependent mediation of hippocampal TARP-γ8-containing AMPARs for synaptic modulation, providing both mechanistic insight and potential clinical implications for optimizing ketamine-based strategies of therapeutics for depression.

Comparable studies

Other preclinical and animal studies on esketamine for depression, most cited first.

Study Year Design Participants
Low-dose S-ketamine exerts antidepressant-like effects via enhanced hippocampal synaptic plasticity in postpartum depression rats. Rat model of postpartum depression induced by reproductive hormone withdrawal 2022 Animal study
Antidepressant effects of esketamine via the BDNF/AKT/mTOR pathway in mice with postpartum depression and their offspring. Mice with postpartum depression and their offspring 2024 Animal study
Electroconvulsive therapy combined with esketamine improved depression through PI3K/AKT/GLT-1 pathway. Human patients with severe depression and a rat model of depression 2025 Randomized controlled trial and animal study n = 12
S-ketamine Alleviates Neuroinflammation and Attenuates Lipopolysaccharide-Induced Depression Via Targeting SIRT2. Lipopolysaccharide (LPS)-induced mouse model 2025 Animal study with in vitro and in vivo experiments
Esketamine alleviates LPS-induced depression-like behavior by activating Nrf2-mediated anti-inflammatory response in adolescent mice. Adolescent male C57BL/6J mice 2025 Preclinical experimental study

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