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Updated: Dec 16, 2025

Network Pharmacology and Validation of the Antidepressant Mechanisms of Qiangzhifang in a Chronic Restraint Stress-induced Depression Rat Model
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Ketamine for depression clinical issues.

Syed Z Iqbal1, Sanjay J Mathew2

  • 1Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States.

Advances in Pharmacology (San Diego, Calif.)
|July 4, 2020
PubMed
Summary
This summary is machine-generated.

Ketamine shows rapid effectiveness for treatment-resistant depression (TRD), offering a new option beyond traditional antidepressants. While short-term safety is established, its potential for abuse requires further investigation for long-term use.

Keywords:
AntidepressantECTEsketamineIntramuscularIntranasal sprayKetamineOral doseRandomized controlled trialSubcutaneous doseSuicide/self-harmTreatment-resistant depression

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Pharmacology

Background:

  • Major depressive disorder (MDD) is a severe mental illness with high morbidity and mortality.
  • Treatment-resistant depression (TRD) affects patients who do not respond to conventional antidepressant therapies.
  • Current antidepressants target monoaminergic systems and require weeks for clinical response.

Purpose of the Study:

  • To review the efficacy and safety of ketamine for treating TRD.
  • To explore ketamine's mechanism of action as an NMDA receptor antagonist.
  • To discuss the administration routes and recent FDA approval of intranasal esketamine for TRD.

Main Methods:

  • Review of existing research on ketamine's use in TRD.
  • Analysis of studies investigating intravenous and intranasal ketamine administration.
  • Examination of safety data, including adverse events.

Main Results:

  • Ketamine demonstrates rapid and robust antidepressant and antisuicidal effects in TRD.
  • Intravenous and intranasal routes are commonly studied for enhanced bioavailability.
  • Short-term adverse events like cardiorespiratory and neuropsychiatric effects are generally transient.

Conclusions:

  • Ketamine represents a significant advancement in TRD treatment.
  • Intranasal esketamine is FDA-approved as an adjunct therapy for TRD.
  • The abuse potential of ketamine necessitates further research for safe long-term application.