NDLI: Risks Associated with Misuse of Ketamine as a Rapid-Acting Antidepressant

Content Provider	Springer Nature Link
Author	Zhu, Weili Ding, Zengbo Zhang, Yinan Shi, Jie Hashimoto, Kenji Lu, Lin
Copyright Year	2016
Abstract	Major depression is a serious psychiatric disorder and remains a leading cause of disability worldwide. Conventional antidepressants take at least several weeks to achieve a therapeutic response and this lag period has hindered their ability to attain beneficial effects in depressed individuals at high risk of suicide. The non-competitive N-methyl-D-aspartate glutamate receptor antagonist ketamine has been shown to have rapid antidepressant effects in both rodents and humans. The emergence of ketamine as a fast-acting antidepressant provides promising new insights into the development of a rapid treatment response in patients with clinical depression. However, its safety and toxicity remain a concern. In this review, we focus on the limitations of ketamine, including neurotoxicity, cognitive dysfunction, adverse events associated with mental status, psychotomimetic effects, cardiovascular events, and uropathic effects. Studies have shown that its safety and tolerability profiles are generally good at low doses and with short-term treatment in depressed patients. The adverse events associated with ketamine usually occur with very high doses that are administered for prolonged periods of time and can be relieved by cessation. The antidepressant actions of its two enantiomers, S-ketamine (esketamine) and R-ketamine, are also discussed. R-ketamine has greater antidepressant actions than S-ketamine, without ketamine-related side-effects. Future treatment strategies should consider using R-ketamine for the treatment of depressed patients to decrease the risk of adverse events associated with long-term ketamine use.
Starting Page	557
Ending Page	564
Page Count	8
File Format	PDF
ISSN	16737067
Journal	Neuroscience Bulletin
Volume Number	32
Issue Number	6
e-ISSN	19958218
Language	English
Publisher	Springer Singapore
Publisher Date	2016-11-22
Publisher Place	Singapore
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Antidepressant Ketamine Fast-acting Depression Safety Neurosciences Human Physiology Anesthesiology Anatomy Neurology Pain Medicine
Content Type	Text
Resource Type	Article
Subject	Neuroscience Physiology Medicine

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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