NMDA receptors are considered targets for many anesthetics if they are modulated by the drugs at clinically relevant concentrations. Volatile anesthetics like isoflurane and ketamine interact with NMDA receptors, inhibiting channel activation and thus blocking NMDA neurotransmission at clinically relevant concentrations. The mode of binding of commonly used drugs like ketamine, isoflurane, and...
Ketamine, a general anesthetic, has rapid and sustained antidepressant effects when administered at lower doses. Anesthetic levels of ketamine reduce excitatory transmission by binding deep into the pore of NMDA receptors where it blocks current influx. In contrast, the molecular targets responsible for antidepressant levels of ketamine remain controversial. We used electrophysiology,...
Ketamine is an N-methyl D-aspartate (NMDA) receptor antagonist used to treat pain at subanesthetic doses. Ketamine is beneficial for pain control in patients who have a high tolerance to opioids and are experiencing opioid-induced hyperalgesia. This study characterizes oral ketamine use for analgesia at a large academic hospital and reports safety outcomes for hospitalized patients. This study...
Major depressive disorder (MDD) is associated with disruptions in glutamatergic and GABAergic activity in the medial prefrontal cortex (mPFC), leading to altered synaptic formation and function. Low doses of ketamine rapidly rescue these deficits, inducing fast and sustained antidepressant effects. While it is suggested that ketamine produces a rapid glutamatergic enhancement in the mPFC, the...
Ketamine, a versatile anesthetic, has seen increased recreational use, leading to significant health issues, including ketamine-induced uropathy (KIU). KIU manifests with lower urinary tract symptoms (LUTS) and can involve the upper urinary tract. This study aims to provide a comprehensive overview of KIU, addressing its pathophysiology, diagnostic strategies, and treatment options; and to...
This analysis sought to identify potential clinical targets for the suicide crisis. Characteristics of a useful clinical target include elevation at the time of suicide crisis and responsiveness to rapid-acting interventions. Suicidal ideation (SI), depression, and hopelessness were hypothesized to meet these criteria. Participants were 118 adults across the continuum of suicide risk, including...
Esketamine has demonstrated acute antidepressant effects in patients with major depressive disorder (MDD). This study investigated whether these effects associate with reversible white matter fiber integrity recovery using diffusion imaging. Twenty patients with MDD and 20 healthy controls received 2-week esketamine treatment. Patients received 0.25 mg/kg intravenous esketamine. Emotional and...
Ketamine, an N-methyl-D-aspartic acid receptor antagonist that was first discovered in 1962, has become established in anaesthesia providing dose-dependent anaesthetic, sedative, and analgesic effects. Ketamine, however, also acts on a wide range of other cellular targets, resulting in interesting and diverse effects on both physiological and pathological processes. Potential beneficial...
Electroconvulsive therapy (ECT) is recognized as one of the most efficacious interventions for depression. However, it is associated with impairments in learning and memory functions. Ketamine has demonstrated potential in mitigating cognitive deficits. Notably, the metabotropic glutamate system is hypothesized to play a pivotal role in cognitive process regulation. Nevertheless, the...
Major depressive disorder with acute suicidal ideation or behavior (MDSI) is a substantial humanistic, economic, and clinical burden on patients. Data on health care resource use (HRU) and costs among patients with MDSI initiated on esketamine nasal spray relative to traditional treatments are limited. This study sought to describe HRU and medical costs of patients with MDSI initiated on...
Chronic ketamine administration causes cognitive impairments similar to those observed in schizophrenia. Growing evidence suggests that patients with schizophrenia show alterations in gut microbiota, which is associated with cognitive impairments. Inulin could regulate gut microbiota. However, it is unclear whether chronic ketamine exposure causes cognitive impairments by mediating gut...
Ketamine is a racemic compound and medication comprised of (S)-ketamine and (R)-ketamine enantiomers and its metabolites. It has been used for decades as a dissociative anesthetic, analgesic, and recreational drug. More recently, ketamine, its enantiomers, and its metabolites have been used or are being investigated for the treatment of refractory depression, as well as for comorbid disorders...
Off-label prescribing of ketamine to treat psychiatric disorders has been increasing, as has recreational use and availability of illicit ketamine. It is important to examine trends in ketamine-related poisonings to inform public health efforts. We examined data from poisonings (exposures) involving ketamine reported to Poison Centers in the US between 2019 and 2023 (n = 1519). Annual trends...
Neurobiology of DiseaseMarch 1, 2025Liubov S. Kalinichenko, Iulia Zoicas, Anne-Marie Bienia et al.4 citations
Addiction is a chronic and severe mental disorder with high gender- and sex-specificity. However, the pathogenesis of this disorder is not fully elucidated, and no targeted pharmacotherapy is available. A growing body of evidence points out the potential involvement of the ceramide system in the pathophysiology of addiction. A pathogenic pathway for several mental disorders based on the...
Treatment-resistant depression (TRD) is related to disproportionate unemployment and productivity burden in the USA. The current study describes real-world mental health (MH)-related disability days and costs of patients with TRD initiated on esketamine nasal spray or conventional therapies in the USA. Adults with TRD were selected from Merative™ MarketScan® Commercial database (from January...
Progress in NeurobiologyMarch 1, 2025Odra Santander, Sebastián B Arredondo, Francisca García-Rojas et al.3 citations
Ketamine administration during adolescence affects cognitive performance; however, its long-term impact on synaptic function and neuronal integration in the hippocampus a brain region critical for cognition remains unclear. Using functional and molecular analyses, we found that chronic ketamine administration during adolescence exerts long-term effects on synaptic integration, expanding the...
Since its synthesis in 1962, ketamine has been widely used in diverse medical contexts, from anesthesia to treatment-resistant depression. However, interpretations of ketamine's subjective effects remain polarized. Biomedical frameworks typically construe the drug's experiential effects as dissociative or psychotomimetic, while psychedelic paradigms emphasize the potential therapeutic merits of...
Intranasal esketamine has been approved as an adjunctive therapy for treatment-resistant major depressive disorder with acute suicidal ideation and behavior. The authors conducted a systematic review and meta-analysis of the available data on its efficacy against depression and suicidality as well as its side effects. MEDLINE was searched with the keyword "esketamine" on March 24, 2024, using...
Ketamine is a dissociative drug used for the treatment of depression. However, the neurofunctional mechanism underlying the antidepressant effect of ketamine remains unknown. According to previous research, low-dose ketamine affects large-scale brain networks, including default-mode and salient networks. A total of 43 patients with treatment-resistant depression (TRD) and suicidal ideation (SI)...
Postictal depression is a common comorbidity in epilepsy, yet effective treatments remain limited. While ketamine is well-known for its antidepressant properties, its role in postictal depression has not been thoroughly investigated. In this study, we utilized a pilocarpine-induced status epilepticus (SE) mouse model and found that depression-like behavior does not appear within a day after SE...