title: Ketamine and other potential glutamate antidepressants.
abstract: The need for rapid acting antidepressants is widely recognised. There has been much interest in glutamate mechanisms in major depressive disorder (MDD) as a promising target for the development of new antidepressants. A single intravenous infusion of ketamine, a N-methyl-d-aspartate (NMDA) receptor antagonist anaesthetic agent, can alleviate depressive symptoms in patients within hours of administration. The mechanism of action appears to be in part through glutamate release onto non-NMDA receptors including α-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and metabotropic receptors. However these are also reported effects on 5-HT, dopamine and intracellular effects on the mammalian target of rapamycin (mTOR) pathway. The effects of SSRI (Selective Serotonin Reuptake Inhibitor) antidepressants may also involve alterations in NMDA function. The article reviews the effect of current antidepressants on NMDA and examines the efficacy and mechanism of ketamine. Response to ketamine is also discussed and comparison with other glutamate drugs including lamotrigine, amantadine, riluzole, memantine, traxoprodil, GLYX-13, MK-0657, RO4917523, AZD2066 and Coluracetam. Future studies need to link the rapid antidepressant effects seen with ketamine to inflammatory theories in MDD.
authors.affiliation: Neuroscience & Psychiatry Unit, Institute of Brain, Behaviour and Mental Health, Stopford Building, University of Manchester, Manchester M13 9PT, UK. Electronic address: arpan.dutta@postgrad.manchester.ac.uk.
authors.forename: Arpan
authors.initials: A
authors.lastname: Dutta
authors.affiliation: Neuroscience & Psychiatry Unit, Institute of Brain, Behaviour and Mental Health, Stopford Building, University of Manchester, Manchester M13 9PT, UK.
authors.forename: Shane
authors.initials: S
authors.lastname: McKie
authors.affiliation: Neuroscience & Psychiatry Unit, Institute of Brain, Behaviour and Mental Health, Stopford Building, University of Manchester, Manchester M13 9PT, UK.
authors.forename: J F William
authors.initials: JFW
authors.lastname: Deakin
mesh_terms: D000818:Animals; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D018698:Glutamic Acid / Q000378:metabolism*; D006801:Humans; D007649:Ketamine / Q000494:pharmacology / Q000627:therapeutic use*; D008559:Memantine / Q000627:therapeutic use; D018091:Receptors, AMPA / Q000187:drug effects; D018094:Receptors, Metabotropic Glutamate / Q000187:drug effects; D016194:Receptors, N-Methyl-D-Aspartate / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D018091:Receptors, AMPA; D018094:Receptors, Metabotropic Glutamate; D016194:Receptors, N-Methyl-D-Aspartate; D018698:Glutamic Acid; D007649:Ketamine; D008559:Memantine
keywords: Glutamate; Ketamine; Major depressive disorder; N-methyl-d-aspartate; α-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid