Depression, Glutamate, and Ketamine: A Brave New World in Antidepressant Medications
Chambers, Jennifer I.
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Chronic stress causes abhorrent neuroplasticity in the hippocampus, amygdala, and prefrontal cortex (PFC) in both animal models and humans. Studies have shown that this can result in depression. Current antidepressant medication onset is between 2-6 weeks, far too long for a person in crisis. The NMDA antagonist ketamine has been shown to provide relief from antidepressant symptoms in as little as 20 min. This may be due to its ability to rapidly activate the production of new synapse proteins, resulting in increased neurotransmission and synaptic plasticity in the PFC. This appears to occur by activating the mTOR signaling pathway and the production of brain-derived neurotrophic factor (BDNF).