Research progress of ketamine and its enantiomers in the treatment of the major depressive disorder
10.3760/cma.j.cn113661-20220111-00009
- VernacularTitle:氯胺酮及其对映异构体治疗抑郁症的研究进展
- Author:
Chunfeng XIAO
1
;
Jingjing ZHOU
1
;
Gang WANG
1
Author Information
1. 首都医科大学附属北京安定医院 国家精神心理疾病临床医学研究中心 精神疾病诊断与治疗北京市重点实验室，北京100088
- Publication Type:Journal Article
- Keywords:
Depressive disorder;
Ketamine;
Pharmacotherapy
- From:
Chinese Journal of Psychiatry
2022;55(4):295-301
- CountryChina
- Language:Chinese
-
Abstract:
Ketamine is a noncompetitive N-methyl-D-aspartate receptor antagonist, as a racemic mixture of two enantiomers (S-ketamine/esketamine and R-ketamine). Ketamine has been a hot topic in the field of psychiatric disorders therapeutics since it was discovered in 1994 that a subanesthetic dose of ketamine could induce a series of psychoactive reactions. By reviewing previous basic research and clinical trials at home and abroad, this study examined the possible mechanisms of action of ketamine and its enantiomers in treating major depressive disorder and their potential clinical risks and benefits to provide preliminary evidence-based guidance for future clinical practice and research in this area field. It was found that ketamine and its enantiomers might exert antidepressant effects relying on a complex mechanism involving multiple receptors and small-molecule systems. Combined with previous reports in the literature, it was hypothesized that ketamine and its enantiomers might exert antidepressant effects through some reticular receptor association system, which is the cascade effect hypothesis proposed in the previous study. Ketamine and its enantiomers can rapidly and effectively treat the major depressive disorder and eliminate suicidal ideation in various psychiatric disorders. Short-term safety is acceptable, but long-term safety lacks high-quality studies. Further research is needed to address the scientific questions in urgent need effectively. Many basic and clinical studies on ketamine and its enantiomers are underway. It is foreseeable that ketamine and its enantiomers will continue to be a hot research topic in the field of depressive disorders therapeutics for some time in the future.
