Redefining Ketamine Pharmacology for Antidepressant Action: Synergistic NMDA and Opioid Receptor Interactions?

American Journal of Psychiatry, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 15, 2025

Ketamine is a racemic compound and medication comprised of (S)-ketamine (R)-ketamine enantiomers its metabolites. It has been used for decades as dissociative anesthetic, analgesic, recreational drug. More recently, ketamine, enantiomers, metabolites have or are being investigated the treatment refractory depression, well comorbid disorders such anxiety, obsessive-compulsive, opioid use disorders. Despite complex pharmacology, ketamine referred to an N-methyl-d-aspartate (NMDA) receptor antagonist. In this review, authors argue that ketamine's pharmacology should be redefined include receptors endogenous system. They also highlight potential mechanism action depression attributed bifunctional, synergistic interactions involving NMDA receptors.

Language: Английский

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Therapeutic mechanisms of psychedelics and entactogens

Neuropsychopharmacology, Journal Year: 2023, Volume and Issue: 49(1), P. 104 - 118

Published: July 24, 2023

Language: Английский

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Perspectives in treatment-resistant depression: esketamine and electroconvulsive therapy

Wiener klinische Wochenschrift, Journal Year: 2024, Volume and Issue: unknown

Published: April 17, 2024

Language: Английский

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Intravenous Ketamine Treatment for Depression: One-year Retrospective Study from a Tertiary Care Psychiatry Center from India

Indian Journal of Psychological Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: April 29, 2025

Major depressive disorder (MDD) is a debilitating mental health condition characterized by significant morbidity and mortality. The emergence of ketamine infusion therapy has provided promising, rapidly acting treatment option. We aimed to assess the effectiveness as an adjunct in patients with depression study patient's profile undergoing real-world clinical setting. This was retrospective chart review. A total 28 who received at tertiary care hospital were included this analysis. Hamilton Depression Rating Scale (HAMD) utilized symptomatology. statistically reduction HAMD scores observed post-treatment (P < .0001). Notably, 53.6% achieved therapeutic response (≥50% decrease score), while 39.3% attained remission (HAMD score 7) after average 4.6 infusions. Furthermore, substantial suicidal ideation 71.4% patients. finding indicates that safe effective for depression.

Language: Английский

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Attitudes and Perceptions of Portuguese Psychiatrists and Psychologists on the Clinical Use of Ketamine

Acta Médica Portuguesa, Journal Year: 2025, Volume and Issue: 38(5), P. 297 - 306

Published: May 2, 2025

Introduction: Ketamine has garnered attention for its rapid efficacy in alleviating depressive symptoms treatment-resistant depression, offering a novel mechanism as non-monoaminergic agent. Despite potential, limited research explored mental health professionals’ perspectives on use. This study assesses the attitudes, knowledge, and concerns of Portuguese psychiatrists psychologists regarding clinical application ketamine depression.Methods: A cross-sectional survey was conducted from June 2022 to January 2024 among psychologists. The anonymous online questionnaire assessed perceptions ketamine’s therapeutic utility, risks, knowledge sources. Statistical analyses examined subgroup differences by age, sex, profession, prior psychedelic use.Results: Among 156 participants (mean age = 37.2; 68.6% female), 53.8% were psychologists, 46.2% or trainees Psychiatry. Only 35.9% reported substantial while 59% open integrating it clinically. majority expressed interest training, though 73% raised about inadequate professional training. Significant emerged, with reporting higher levels openness compared younger professionals showed greater training usage.Conclusion: There favorable attitude toward use yet educational gaps remain. Customized addressing background is essential safe effective integration depression. Further studies should focus longitudinal outcomes treatment under standardized protocols ensure safety practice.

Language: Английский

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Ketamine for depressive symptoms: A retrospective chart review of a private ketamine clinic

South African Journal of Psychiatry, Journal Year: 2024, Volume and Issue: 30

Published: Feb. 8, 2024

There is currently no published evidence demonstrating the effectiveness and safety of subanaesthetic doses ketamine, when administered intravenously as an adjunct treatment for depressive symptoms, in a real world setting South Africa.

Language: Английский

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Pluripotential GluN1 (NMDA NR1): Functional Significance in Cellular Nuclei in Pain/Nociception

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(17), P. 13196 - 13196

Published: Aug. 25, 2023

The N-methyl-D-aspartate (NMDA) glutamate receptors function as plasma membrane ionic channels and take part in very tightly controlled cellular processes activating neurogenic inflammatory pathways. In particular, the NR1 subunit (new terminology: GluN1) is required for many neuronal non-neuronal cell functions, including plasticity, survival, differentiation. Physiologic levels of agonists NMDA receptor activation are normal functions such development, learning, memory. When present excess, binding to produces neuronal/CNS/PNS long-term potentiation, conditions acute pain, ongoing severe intractable potential excitotoxicity pathology. GluNR1 (116 kD) necessary anchor component directing ion channel heterodimer formation, trafficking, nuclear localization that directs functionally specific functions. Emerging studies report relevance GluN1 composition specifically has major physiologic tissue and/or subnuclear functioning assignments. shift from a surface assigns promoter immediate early gene behavior with access potentially nucleolar narrative review addresses translocation GluN1, focusing particularly on examples role nociceptive processes.

Language: Английский

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Prolonged ketamine therapy differentially rescues psychobehavioural deficits via modulation of nitro-oxidative stress and oxytocin receptors in the gut-brain-axis of chronically-stressed mice

Psychoneuroendocrinology, Journal Year: 2023, Volume and Issue: 158, P. 106370 - 106370

Published: Aug. 23, 2023

Language: Английский

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Improvement of Mental Health Symptoms in Response to Ketamine Therapy in Medicaid-Eligible Patients

Journal of Psychiatry and Mental Health, Journal Year: 2024, Volume and Issue: 8(1)

Published: Jan. 1, 2024

Since 2020 there has been an expansion in the number of studies highlighting positive effect that Ketamine for Non-Anesthetic Indications (KNAI) can have on patients suffering with mental health disorders. Medicaid programs cover a large community face significant disparities and suffer more frequently from conditions. Many these conditions are exacerbated due to socioeconomic stressors, lack access care, poor support systems. Our case study focuses 289 Medicaid-eligible ketamine treatment had their symptoms. These participants established diagnosis Generalized Anxiety Disorder (GAD), Major Depressive (MDD) and/or Post Traumatic Stress (PTSD) prior beginning treatment. The GAD-7, PHQ-9, PCL-5 surveys were utilized assessment symptomatology this cohort patients. instruments all deployed at end six-session Induction Series treatments. comparison scores screening pre-and post-treatment demonstrated clinically reduction three cohorts listed above.

Language: Английский

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Embracing pragmatism for ketamine insurance coverage: Leveraging real-world evidence

Journal of Affective Disorders, Journal Year: 2024, Volume and Issue: 352, P. 199 - 200

Published: Feb. 11, 2024

Language: Английский

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