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The promise of ketamine for treatment‐resistant depression: current evidence and future directions
Author(s) -
DeWilde Kaitlin E.,
Levitch Cara F.,
Murrough James W.,
Mathew Sanjay J.,
Iosifescu Dan V.
Publication year - 2015
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/nyas.12646
Subject(s) - ketamine , major depressive disorder , antidepressant , anhedonia , psychology , psychopathology , nmda receptor , medicine , psychiatry , treatment resistant depression , neuroscience , pharmacology , cognition , schizophrenia (object oriented programming) , receptor , anxiety
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.