%0 Journal Article
%T Ketamine-based Treatment of MDD: A Biologist¡¯s Perspective - Ketamine-based Treatment of MDD: A Biologist¡¯s Perspective - Open Access Pub
%A Qiang Zhou
%A Yingli Zhang
%J OAP | Home | Journal of Depression And Therapy | Open Access Pub
%D 2017
%X Ketamine¡¯s potential as a fast-acting reagent to treat MDD, especially treatment-resistant depression has caught much attention recently. Although much has been learned about the biological mechanisms underlying ketamine¡¯s effect, there are a few critical issues remained to be resolved. This mini review will briefly discuss several controversial issues that warrant further studies, regarding the molecular, physiological, psychopharmacological, and behavioral effects of ketamine. Understand how ketamine works as an anti-depressant will open the door to better understanding of MDD and its treatment. DOI10.14302/issn.2476-1710.jdt-17-1673 Despite current available antidepressants, major depressive disorder (MDD) presents as a major threat to public health, with a lifetime prevalence of 17% in the United States and 40-50% of patients unresponsive to treatment1. Moreover, the slow onset of therapeutic ef£¿cacy that usually takes 3 - 4 weeks is especially unhelpful for patients with suicidal ideation. Combined with treatment for resistant and accompanied comorbid anxiety disorders, a novel and rapidly acting antidepressant is highly desirable2. Ketamine is a low-affinity, activity-dependent, open channel blocker of NMDA subtype glutamate receptors (NMDARs). Ketamine has been shown to be effective in treating major depressive disorder (MDD), including treatment-resistant depression, with a rapid onset (on the order of hours) of efficacy and effective duration of days to weeks3, 4, 5. A few potential issues have been identified during the clinical testing of ketamine, which need to be resolved before ketamine or its derivatives/metabolites could be widely applied clinically. These improvements should come from a better understanding of biology of ketamine¡¯s efficacy. In this review, we will discuss the proposed biological mechanisms and critical unresolved issues related to ketamine¡¯s anti-depressant effects. Clinical Effects and Potential Biological Mechanisms After the serendipitous discovery of its antidepressant effects, ketamine has been successfully applied as a fast acting treatment of MDD in a clinical setting, especially for treatment-resistant MDD patients3, 4, 5. Its short-lasting and quick dissipating antidepressant properties requires repeated administration to keep its efficacy, while repetitive administration is severely limited by psychostimulant effects and addictive potentials6. It is in debate as whether these two side effects may be intricately connected to ketamine¡¯s antidepressant effects7. A few biological mechanisms have been proposed for
%U https://www.openaccesspub.org/jdt/article/541