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Human in vivo assessment of ketamine binding of the serotonin transporter-follow
up at a higher dose
#MMPMID41113438
Schlosser G
; Murga? M
; Godbersen GM
; Reichel S
; Silberbauer L
; Nics L
; Winkler D
; Stimpfl T
; Hacker M
; Kasper S
; Rujescu D
; Lanzenberger R
; Spies M
Front Neurosci
2025[]; 19
(?): 1651016
PMID41113438
show ga
Ketamine is a rapid-acting antidepressant approved in the indication of
treatment-resistant depression. As its clinical use expands, identifying
underlying molecular mechanisms is essential. The serotonin transporter (SERT) is
well known as a primary mechanism of several classes of monoaminergic
antidepressants. Binding of ketamine to SERT has been observed in vitro and in
animal studies with macaque monkeys using positron emission tomography (PET). We
previously reported that a 0.5?mg/kg body weight dose of ketamine did not
significantly bind to SERT in healthy human subjects assessed with PET but
observed a positive trend between binding and ketamine plasma levels. Based on
this finding, we hypothesized that a higher dose (0.8?mg/kg) would result in
measurable SERT occupancy. Here, 10 healthy male participants were measured twice
with [(11)C]DASB PET to test SERT occupancy following administration of 0.8?mg/kg
body weight ketamine in four selected SERT rich regions amygdala, putamen,
caudate and thalamus. Further, we implemented a bolus-plus-infusion radioligand
infusion protocol and optimized the timing of the ketamine infusion. Contrary to
our hypothesis, ketamine SERT occupancy did not significantly differ from zero,
and the area under the curve of ketamine and norketamine plasma levels was not
correlated with occupancy. These results suggest that even at doses up to
0.8?mg/kg, ketamine does not appreciably bind to SERT in humans, aligning with
clinical observations that ketamine is routinely combined with serotonergic
agents. CLINICAL TRIAL REGISTRATION: http://clinicaltrials.gov, identifier,
NCT02582398. EUDAMED number, CIV-AT-13-01-009583.