Ketamine's dose related multiple mechanisms of actions: Dissociative anesthetic to rapid antidepressant.
Dissociative effects
Enantiomers
Ketamine
Mechanisms of action
Metabolites
Rapid antidepressant
Journal
Behavioural brain research
ISSN: 1872-7549
Titre abrégé: Behav Brain Res
Pays: Netherlands
ID NLM: 8004872
Informations de publication
Date de publication:
15 07 2020
15 07 2020
Historique:
received:
24
11
2019
revised:
19
03
2020
accepted:
29
03
2020
pubmed:
22
5
2020
medline:
26
10
2021
entrez:
22
5
2020
Statut:
ppublish
Résumé
Ketamine induces safe and effective anesthesia and displays unusual cataleptic properties that gave rise to the term dissociative anesthesia. Since 1970, clinicians only utilized the drug as an anesthetic or analgesic for decades, but ketamine was found to have rapid acting antidepressant effects in 1990s. Accumulated evidence exhibits NMDAR antagonism may not be the only mechanism of ketamine. The contributions of AMPA receptor, mTor signal pathway, monoaminergic system, sigma-1 receptor, cholinergic, opioid and cannabinoid systems, as well as voltage-gated calcium channels and hyperpolarization cyclic nucleotide gated channels are discussed for the antidepressant effects. Also the effects of ketamine's enantiomers and metabolites are reviewed. Furthermore ketamine's anesthetic and analgesic mechanisms are briefly revisited. Overall, pharmacology of ketamine, its enantiomers and metabolites is very unique. Insight into multiple mechanisms of action will provide further development and desirable clinical effects of ketamine.
Identifiants
pubmed: 32437885
pii: S0166-4328(20)30330-2
doi: 10.1016/j.bbr.2020.112631
pii:
doi:
Substances chimiques
Anesthetics, Dissociative
0
Antidepressive Agents
0
Receptors, Neurotransmitter
0
Ketamine
690G0D6V8H
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
112631Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.