title: The promise of ketamine for treatment-resistant depression: current evidence and future directions.
abstract: Major depressive disorder (MDD) is one of the most disabling diseases worldwide and is becoming a significant public health threat. Current treatments for MDD primarily consist of monoamine-targeting agents and have limited efficacy. However, the glutamate neurotransmitter system has recently come into focus as a promising alternative for novel antidepressant treatments. We review the current data on the glutamate NMDA receptor antagonist ketamine, which has been shown in clinical trials to act as a rapid antidepressant in MDD. We also examine ketamine efficacy on dimensions of psychopathology, including anhedonia, cognition, and suicidality, consistent with the NIMH Research Domain Criteria initiative. Other aspects of ketamine reviewed in this paper include safety and efficacy, different administration methods, and the risks of misuse of ketamine outside of medical settings. Finally, we conclude with a discussion of glutamatergic agents other than ketamine currently being tested as novel antidepressants.
authors: Mood and Anxiety Disorders Program, Icahn School of Medicine at Mount Sinai, New York, New York.
authors: Kaitlin E
authors: KE
authors: DeWilde
authors: Mood and Anxiety Disorders Program, Icahn School of Medicine at Mount Sinai, New York, New York.
authors: Cara F
authors: CF
authors: Levitch
authors: Mood and Anxiety Disorders Program, Icahn School of Medicine at Mount Sinai, New York, New York.
authors: James W
authors: JW
authors: Murrough
authors: Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas.
authors: Sanjay J
authors: SJ
authors: Mathew
authors: Mood and Anxiety Disorders Program, Icahn School of Medicine at Mount Sinai, New York, New York.
authors: Dan V
authors: DV
authors: Iosifescu
mesh_terms: D059445:Anhedonia / Q000187:drug effects; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D061218:Depressive Disorder, Treatment-Resistant / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D004351:Drug Resistance; D006801:Humans; D007649:Ketamine / Q000627:therapeutic use*; D019964:Mood Disorders / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D017211:Treatment Failure
chemical_list: D000928:Antidepressive Agents; D007649:Ketamine
keywords: antidepressant; bipolar disorder; ketamine; major depressive disorder; treatment resistant
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