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2018 ; 5
(1
): 36-47
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Rapid-Acting Antidepressants: Mechanistic Insights and Future Directions
#MMPMID30034992
Gerhard DM
; Duman RS
Curr Behav Neurosci Rep
2018[Mar]; 5
(1
): 36-47
PMID30034992
show ga
PURPOSE OF REVIEW: Ketamine produces rapid (within hours) antidepressant actions,
even in patients considered treatment resistant, and even shows promise for
suicidal ideation. Here, we review current research on the molecular and cellular
mechanisms of ketamine and other novel rapid-acting antidepressants, and briefly
explore gender differences in the pathophysiology and treatment of MDD. RECENT
FINDINGS: Ketamine, an NMDA receptor antagonist, increases BDNF release and
synaptic connectivity, opposing the deficits caused by chronic stress and
depression. Efforts are focused on the development of novel rapid agents that
produce similar synaptic and rapid antidepressant actions, but without the side
effects of ketamine. The impact of gender on the response to ketamine and other
rapid-acting antidepressants is in early stages of investigation. SUMMARY: The
discovery that ketamine produces rapid therapeutic actions for depression and
suicidal ideation represents a major breakthrough and much needed alternative to
currently available medications. However, novel fast acting agents with fewer
side effects are needed, as well as elucidation of the efficacy of these
rapid-acting antidepressants for depression in women.