| Zhang Kai,Cheng Zhaoyang,Wang Yuting,Advances in ketamine therapy for multiple psychiatric disorders[J].SICHUAN MENTAL HEALTH,2025,(4):289-294 |
| Advances in ketamine therapy for multiple psychiatric disorders |
DOI：10.11886/scjsws20250531003 |
| English keywords:Ketamine Esketamine Rapid antidepressant NMDA receptor Psychiatric disorders |
| Fund projects:安徽省教育厅高校自然科学研究重点项目（项目名称：R-氯胺酮经小胶质细胞TGF-β-ERK/MAPK信号通路快速抗抑郁机制研究；项目编号：2023AH050647）；安徽省教育厅2022年高校优秀青年人才支持计划项目（项目编号：gxyqZD2022022） |
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| Ketamine， a non-competitive N-methyl-D-aspartate （NMDA） receptor antagonist， has gained increasing attention for its rapid antidepressant effects in treatment-resistant depression （TRD） and suicidal ideation. Its mechanisms include NMDA receptor blockade， AMPA receptor activation， and upregulation of BDNF/mTOR signaling. Its enantiomers， esketamine and R-ketamine， as well as its metabolites， exhibit differences in efficacy and mechanisms. Intranasal esketamine has been approved in the Europe， United States， and China for TRD， demonstrating rapid efficacy in alleviating depressive symptoms and acute suicidal ideation. In contrast， R-ketamine demonstrates potential for longer-lasting effects and a improved safety profile. This review summarizes recent advances in the pharmacology， pharmacokinetics， and clinical applications of ketamine and its enantiomers in depressive disorders， bipolar disorder， substance use disorders， post-traumatic stress disorder and obsessive-compulsive disorder. Despite ketamine's multifaceted therapeutic potential， safety concerns such as dissociation， cognitive impairment， and abuse liability warrant continued attention.［Funded by Key Project of Natural Science Research for Universities of Anhui Provincial Education Department （number， 2023AH050647）； Anhui Provincial Department of Education Outstanding Young Talent Support Program Project 2022 （number， gxyqZD2022022）］ |
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