Ketamine and its two enantiomers in anesthesiology and psychiatry: A historical review and future directions

Journal of Anesthesia and Translational Medicine, Journal Year: 2024, Volume and Issue: 3(3), P. 65 - 75

Published: July 11, 2024

Ketamine, a dissociative anesthetic, is widely utilized in both human and veterinary anesthesia. Its (S)-enantiomer, esketamine, similarly employed for anesthesia analgesia. The anesthetic effects of ketamine esketamine arise from their antagonism the N-methyl-D-aspartate receptor (NMDAR). In field psychiatry, rapid-acting antidepressant properties severe depression have generated significant interest, resulting its increased off-label usage United States (U.S.). 2019, nasal spray received approval use U.S. Europe. However, concerns emerged regarding potential adverse effects, including long-term efficacy, addiction risks, suicide risk clinical settings. contrast, arketamine, (R)-enantiomer ketamine, exhibits superior longer-lasting rodent models depression, with fewer side compared to esketamine. Nevertheless, research on efficacy safety arketamine patients remains limited. This article provides concise exploration historical two enantiomers while also delving into future directions application these fields.

Language: Английский

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Bio-gel nanoarchitectonics in tissue engineering

Nanoscale, Journal Year: 2024, Volume and Issue: 16(28), P. 13230 - 13246

Published: Jan. 1, 2024

Nanoarchitectonics may be highly compatible with applications in biological systems. Construction strategies and functions of bio-gel nanoarchitectonics medical tissue engineering are discussed.

Language: Английский

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Therapeutic Approaches to the Neurologic Manifestations of COVID-19

Neurotherapeutics, Journal Year: 2022, Volume and Issue: 19(5), P. 1435 - 1466

Published: July 21, 2022

Language: Английский

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Sigma-1 Receptors in Depression: Mechanism and Therapeutic Development

Frontiers in Pharmacology, Journal Year: 2022, Volume and Issue: 13

Published: June 16, 2022

Depression is the most common type of neuropsychiatric illness and has increasingly become a major cause disability. Unfortunately, recent global pandemic COVID-19 dramatically increased incidence depression significantly burden mental health care worldwide. Since full remission clinical symptoms not been achieved with current treatments, there constant need to discover new compounds that meet needs. Recently, roles sigma receptors, especially sigma-1 receptor subtype, have attracted increasing attention as potential targets target-specific drugs due their translocation property produces broad spectrum biological functions. Even first-line antidepressants or without affinity for receptors different pharmacological profiles. Thus, regulatory role might be useful in treating these central nervous system (CNS) diseases. In addition, long-term stress disrupts homeostasis CNS. this review, we discuss topical literature concerning antidepressant mechanism action regulation intracellular proteostasis, calcium dynamic Excitatory/Inhibitory (E/I) balance brain. Furthermore, based on discoveries, ligands respect promise fast-onset depression.

Language: Английский

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Sigma-1 Receptor Signaling: In Search of New Therapeutic Alternatives for Cardiovascular and Renal Diseases

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(3), P. 1997 - 1997

Published: Jan. 19, 2023

Cardiovascular and renal diseases are among the leading causes of death worldwide, regardless current efforts, there is a demanding need for therapeutic alternatives to reduce their progression advanced stages. The stress caused by leads activation protective mechanisms in cell, including chaperone proteins. Sigma-1 receptor (Sig-1R) ligand-operated protein that modulates signal transduction during cellular processes. Sig-1R interacts with various ligands proteins elicit distinct responses, thus, making it potential target pharmacological modulation. Furthermore, activate signaling pathways promote cardioprotection, ameliorate ischemic injury, drive myofibroblast fibrosis. role has also made point interest developing clinical trials pain, neurodegeneration, stroke, depression patients heart failure, COVID-19. preclinical models have significantly beneficial effects associated improved cardiac function, ventricular remodeling, hypertrophy reduction, and, kidney, reduced damage. These basic discoveries could inform failure (HF), myocardial hypertrophy, acute kidney injury (AKI), chronic disease (CKD). Here, we review evidence modulation support use agonists antagonists these diseases.

Language: Английский

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Overview of the potential use of fluvoxamine for COVID-19 and long COVID

Discover Mental Health, Journal Year: 2023, Volume and Issue: 3(1)

Published: March 21, 2023

Abstract Coronavirus disease 2019 (COVID-19) has presented a serious worldwide threat to public health since its emergence in late 2019. From safety point of view, drug repurposing received particular attention. Several clinical studies have demonstrated that the use fluvoxamine, selective serotonin reuptake inhibitor with potent sigma-1 receptor agonism, early-stage infection might be associated prevention deterioration individuals SARS-CoV-2 infection, although several reports shown low dose fluvoxamine may ineffective. There is increasing evidence can cross blood–brain barrier, resulting number psychiatric and neurologic symptoms COVID-19 survivors. Importantly, about half survivors experience variety long-term sequelae, including symptoms, known as long COVID. In this priority review, author presents an overview potential treatment

Language: Английский

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Higher-Dose Fluvoxamine and Time to Sustained Recovery in Outpatients With COVID-19

JAMA, Journal Year: 2023, Volume and Issue: 330(24), P. 2354 - 2354

Published: Nov. 17, 2023

The effect of higher-dose fluvoxamine in reducing symptom duration among outpatients with mild to moderate COVID-19 remains uncertain.

Language: Английский

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Soluble Epoxide Hydrolase as a Therapeutic Target for Neuropsychiatric Disorders

International Journal of Molecular Sciences, Journal Year: 2022, Volume and Issue: 23(9), P. 4951 - 4951

Published: April 29, 2022

It has been found that soluble epoxide hydrolase (sEH; encoded by the EPHX2 gene) in metabolism of polyunsaturated fatty acids (PUFAs) plays a key role inflammation, which, turn, part pathogenesis neuropsychiatric disorders. Meanwhile, epoxy such as epoxyeicosatrienoic (EETs), epoxyeicosatetraenoic (EEQs), and epoxyeicosapentaenoic (EDPs) have to exert neuroprotective effects animal models disorders through potent anti-inflammatory actions. Soluble expoxide hydrolase, an enzyme present all living organisms, metabolizes into corresponding dihydroxy acids, which are less active than precursors. In this regard, preclinical findings using sEH inhibitors or Ephx2 knock-out (KO) mice indicated inhibition deficiency can beneficial several Thus, review discusses current disorders, including depression, autism spectrum disorder (ASD), schizophrenia, Parkinson’s disease (PD), stroke, well potential mechanisms underlying therapeutic inhibitors.

Language: Английский

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The effect of antidepressants on the severity of COVID-19 in hospitalized patients: A systematic review and meta-analysis

PLoS ONE, Journal Year: 2022, Volume and Issue: 17(10), P. e0267423 - e0267423

Published: Oct. 6, 2022

Introduction Clinical Depression and the subsequent low immunity is a comorbidity that can act as risk factor for severity of COVID-19 cases. Antidepressants such Selective serotonin reuptake inhibitor Serotonin-norepinephrine inhibitors are associated with immune-modulatory effects, which dismiss inflammatory responses reduce lung tissue damage. The current systematic review meta-analysis aims to evaluate effect antidepressant drugs on prognosis in hospitalized patients. Methods A search was carried out PubMed/Medline, EMBASE, Scopus up June 14, 2022. following keywords were used: "COVID-19", "SARS-CoV-2", "2019-nCoV", "SSRI", "SNRI", “TCA”, “MAOI”, “Antidepressant”. fixed or random-effect model assessed pooled ratio (RR) 95% CI. We considered P < 0.05 statistically significant publication bias. Data analyzed by Comprehensive Meta-Analysis software, Version 2.0 (Biostat, Englewood, NJ). Results Fourteen studies included our review. Five them experimental 2350, nine observational 290,950 participants. Eight fourteen articles revealed antidepressants reducing COVID-19. drugs, including Fluvoxamine, Escitalopram, Fluoxetine, Paroxetine, among medications Venlafaxine, reasonably reduced intubation death. showed no effect, only one high bias article negative Covid-19. clinical trials fluvoxamine could significantly decrease outcomes (RR: 0.763; CI: 0.602–0.966, I2: 0.0) Findings Most evidence supports use medications, mainly may improve outcome patients SARS-CoV-2. Some contradictory findings regarding effects Further should be conducted clarify

Language: Английский

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Antidepressant Use and Its Association with 28-Day Mortality in Inpatients with SARS-CoV-2: Support for the FIASMA Model against COVID-19

Journal of Clinical Medicine, Journal Year: 2022, Volume and Issue: 11(19), P. 5882 - 5882

Published: Oct. 5, 2022

To reduce Coronavirus Disease 2019 (COVID-19)-related mortality and morbidity, widely available oral COVID-19 treatments are urgently needed. Certain antidepressants, such as fluvoxamine or fluoxetine, may be beneficial against COVID-19. We included 388,945 adult inpatients who tested positive for SARS-CoV-2 at 36 AP−HP (Assistance Publique−Hôpitaux de Paris) hospitals from 2 May 2020 to November 2021. compared the prevalence of antidepressant use admission in a 1:1 ratio matched analytic sample with without (N = 82,586), assessed its association 28-day all-cause 1482). Antidepressant was significantly less prevalent than control group (1.9% versus 4.8%; Odds Ratio (OR) 0.38; 95%CI 0.35−0.41, p < 0.001). associated reduced among (12.8% 21.2%; OR 0.55; 0.41−0.72, 0.001), particularly daily doses least 40 mg fluoxetine equivalents. Antidepressants high FIASMA (Functional Inhibitors Acid Sphingomyelinase) activity seem drive both associations. These infections COVID-19-related inpatients, appropriate prophylaxis and/or therapy outpatients inpatients.

Language: Английский

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