NMDAR inhibition-independent antidepressant actions of ketamine metabolites

NMDAR inhibition-independent antidepressant actions of ketamine metabolites

2016 November 04 | Panos Zanos, Ruin Moaddel, Patrick J. Morris, Polymnia Georgiou, Jonathan Fischell, Greg I. Elmer, Manickavasagom Alkondom, Peixiong Yuan, Heather J. Pribut, Nagendra S. Singh, Katina S.S. Dossou, Yuhong Fang, Xi-Ping Huang, Cheryl L. Mayo, Irving W. Wainer, Edson X. Albuquerque, Scott M. Thompson, Craig J. Thomas, Carlos A. Zarate Jr., and Todd D. Gould
The study investigates the antidepressant actions of ketamine metabolites, specifically (2S,6S,2R,6R)-hydroxynorketamine (HNK), and its enantiomer (2R,6R)-HNK, which are independent of NMDAR inhibition. Ketamine, a non-competitive NMDAR antagonist, has been shown to exert rapid and sustained antidepressant effects in depressed patients. The research demonstrates that the metabolism of ketamine to (2S,6S,2R,6R)-HNK is essential for its antidepressant effects, and that (2R,6R)-HNK exerts these effects in vivo. Notably, these actions are independent of NMDAR inhibition but involve early and sustained activation of AMPA receptors. The study also shows that (2R,6R)-HNK lacks the side effects associated with ketamine, such as sensory gating disruption and drug discrimination responses. These findings suggest a novel mechanism for ketamine's antidepressant properties and highlight the potential for developing next-generation, rapid-acting antidepressants based on (2R,6R)-HNK.The study investigates the antidepressant actions of ketamine metabolites, specifically (2S,6S,2R,6R)-hydroxynorketamine (HNK), and its enantiomer (2R,6R)-HNK, which are independent of NMDAR inhibition. Ketamine, a non-competitive NMDAR antagonist, has been shown to exert rapid and sustained antidepressant effects in depressed patients. The research demonstrates that the metabolism of ketamine to (2S,6S,2R,6R)-HNK is essential for its antidepressant effects, and that (2R,6R)-HNK exerts these effects in vivo. Notably, these actions are independent of NMDAR inhibition but involve early and sustained activation of AMPA receptors. The study also shows that (2R,6R)-HNK lacks the side effects associated with ketamine, such as sensory gating disruption and drug discrimination responses. These findings suggest a novel mechanism for ketamine's antidepressant properties and highlight the potential for developing next-generation, rapid-acting antidepressants based on (2R,6R)-HNK.
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