Exploring the multifaceted potential of (R)-ketamine beyond antidepressant applications.
Senbing Zhang, Yanzhu Pu, Jianning Liu, Lewen Li, Chibing An, Yumin Wu, Wenjie Zhang, Wenxia Zhang, Song Qu, Wenjun Yan
Frontiers in pharmacology January 1, 2024 DOI: 10.3389/fphar.2024.1337749 via PubMed
Summary
AI-generated from the abstract(R)-ketamine shows promise for treatment-resistant depression with fewer psychomimetic and dissociative side effects than (R,S)- or (S)-ketamine, but a recent small randomized controlled trial found its antidepressant efficacy did not surpass placebo in adults. The compound may also have applications in cognitive disorders, stroke, Parkinson's disease, multiple sclerosis, osteoporosis, substance use disorders, inflammatory diseases, COVID-19, and organophosphate poisoning. This review covers (R)-ketamine's mechanisms and antidepressant research, highlighting its potential and need for further verification.
Study at a glance
| Characteristics | Review Randomized Peer reviewed |
|---|---|
| Topics | Depression |
| Keywords | Antidepressant efficacy Cognitive disorders Ischemic stroke Side effects |
| Citations | 12 |
| Key finding | (R)-ketamine may have fewer side effects than other ketamine forms, but its antidepressant efficacy was not superior to placebo in a small trial, and its broader medical applications require more research. |
Abstract
(R, S)- and (S)-ketamine have made significant progress in the treatment of treatment-resistant depression (TRD) and have become a research focus in recent years. However, they both have risks of psychomimetic effects, dissociative effects, and abuse liability, which limit their clinical use. Recent preclinical and clinical studies have shown that (R)-ketamine has a more efficient and lasting antidepressant effect with fewer side effects compared to (R, S)- and (S)-ketamine. However, a recent small-sample randomized controlled trial found that although (R)-ketamine has a lower incidence of adverse reactions in adult TRD treatment, its antidepressant efficacy is not superior to the placebo group, indicating its antidepressant advantage still needs further verification and clarification. Moreover, an increasing body of research suggests that (R)-ketamine might also have significant applications in the prevention and treatment of medical fields or diseases such as cognitive disorders, perioperative anesthesia, ischemic stroke, Parkinson's disease, multiple sclerosis, osteoporosis, substance use disorders, inflammatory diseases, COVID-19, and organophosphate poisoning. This article briefly reviews the mechanism of action and research on antidepressants related to (R)-ketamine, fully revealing its application potential and development prospects, and providing some references and assistance for subsequent expanded research.