Ketamine in affective disorders – expectations and limitations

Ewelina Soroka, Dorota Adamczyk, Katarzyna Adamczyk, Urszula Fałkowska, Marcin Olajossy


Classified as dissociative psychedelic, ketamine is a psychoactive agent whose exact mechanism of action has not been fully elucidated. In human and veterinary medicine ketamine is administered during preoperative analgesia. In anesthesiology it is employed either during induction of complex anesthesia or rarely, as a mono-anesthetic agent implemented in short-time procedures that do not cause visceral pain. Hallucinations, nausea, vomiting and elevation of systemic and intracranial pressure may be listed among adverse drug reactions limiting the use of ketamine. Ketamine is believed to exert antidepressant effects by antagonizing N-Methyl-D-aspartate receptor (NMDAR), combined with its presumptive inhibitory action on noradrenaline and serotonin transporter. Unlike other antidepressants, requiring weeks to exert apparent effects, ketamine relieves depressive symptoms within hours from administration. First reports on ketamine efficacy in the treatment of depressive episode come from 2000. The use of ketamine appears to be beneficial in patients who have exhausted other possible pharmacotherapeutic options. Current data suggest that single ketamine infusion is suitable for patients with treatment-resistant unipolar or bipolar depression without psychotic features, and with no previous history of psychoactive substance abuse. The prospective therapeutical applications of ketamine in the treatment of affective disorders are promising, however, further comprehensive research is still required.


ketamine; NMDA antagonist; affective disorder; depression

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Ketamine in the bases: PubChem, United States National Library of Medicine.,,

Grady SE, Marsh TA, Tenhouse A et al.: Ketamine for the treatment of major depressive disorder and bipolar depression: a review of the literature. Mental Health Clinician 2017; 16: 16–23.

Li JH, Vicknasingam B, Cheung YW et al.: To use or not to use: an update on licit and illicit ketamine use. Subst Abuse Rehabil 2011; 2: 11–20.

Skolnick P, Popik P, Trullas R: Glutamate-based antidepressants: 20 years on. Trends Pharmacol Sci 2009; 30: 563–569.

Zhao Y, Sun LJ: Antidepressants modulate the in vitro inhibitory effects of propofol and ketamine on norepinephrine and serotonin transporter function. ClinNeurosci 2008; 15: 1264–1269.

Hijazi Y, Boulieu R: Contribution of CYP3A4, CYP2B6, and CYP2C9 isoforms to N-demethylation of ketamine in human liver microsomes. Drug MetabDispos 2002; 30: 853–858.

Ledford H:Nature News & Comment 5 (2016).

Rybakowski J: Nowe kierunki farmakoterapii choroby afektywnej dwubiegunowej. Farmakoterpia w PsychiatriiiNeurologii 2013; 1: 5–11.

Berman RM, Cappiello A, Anand A et al.: Antidepressant effects of ketamine in depressed patients. Biol Psychiatry 2000; 47: 351–354.

Zarate CA, Singh JB, Carlson PJ et al.: A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Arch Gen Psychiatry 2006; 63: 856–864.

Diazgranados N, Ibrahim L, Brutsche NE et al.: A randomized add-on trial of an N-methyl-d-aspartate antagonist in treatment-resistant bipolar depression. Arch Gen Psychiatry 2010; 67: 793–802.

Lapidus KA, Levitch CF, Perez AM et al.: A randomized controlled trial of intranasal ketamine in major depressive disorder. Biol Psychiatry 2014; 76: 970–976.

Murrough JW, Iosifescu DV, Chang LC et al.: Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial. Am J Psychiatry 2013; 170: 1134–1142.

Murrough JW, Burdick KE, Levitch CF et al.: Neurocognitive effects of ketamine and association with antidepressant response in individuals with treatment-resistant depression: a randomized controlled trial. Neuropsychopharmacology 2015; 40: 1084–1090.

Brennan BP, Hudson JI, Jensen JE et al.: An examination of rostral anterior cingulate cortex function and neurochemistry in obsessive–compulsive disorder. Neuropsychopharmacology 2015; 40: 1866–1876.

Calabrese JR, Ketter TA, Cucchiaro J et al.: Lurasidone adjunctive to lithium or valproate for the treatment of bipolar depression: results of a 6-week, double-blind, placebo-controlled study (PREVAIL-1). The 13th International Review of Bipolar Disorders, Seville, 18–20 March 2013. Abstract Book, 15.

Coppola M, Mondola R.: Palmitoylethanolamide: from endogenous cannabimimetic substance to innovative medicine for the treatment of cannabis dependence. Med Hypotheses 2013; 81:619–622.

Preskorn SH, Baker B, Kolluri S et al.: An innovative design to establish proof of concept of the antidepressant effects of the NR2B subunit selective N-methyl-D-aspartate antagonist, CP-01,606, in patients with treatment-refractory major depressive disorder. J Clin Psycho-pharmacol 2008; 28: 631–637.

Romeo B, Choucha W, Fossati P et al.: Meta-analysis of short- and mid-term efficacy of ketamine in unipolar and bipolar depression. Psychiatry Res 2015; 230:682–688.

Smith DJ, Azzaro AJ, Zaldivar SB et al.: Properties of the optical isomers and metabolites of ketamine on the high affinity transport and catabolism of monoamines. Neuropharmacol 1981; 20:391–396.

Gosek P, Chojnacka M, Bieńkowski P et al.: Antidepressant effect of ketamine, a N-methyl-D-aspartate (NMDA) glutamate receptor antagonist, in the therapy of treatment-resistant depression. Psychiatr Pol 2012; 46:283–294.

Tuck AN, Ghazali DH: Ketamine as a rapid-acting antidepressant: promising clinical and basic research. American Journal of Psychiatry Residents' Journal 2017; 12: 3–5.

Mathew SJ, Zarate Jr.CA: Ketamine for Treatment-Resistant Depression: The First Decade of Progress. Springer, 2016.

Murrough JW, Iosifescu DV, Chang LC et al.: Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial. American Journal of Psychiatry 2013; 170:1134–1142.

Poleszak E, Stasiuk W, Szopa A et al.: Traxoprodil, a selective antagonist of the NR2B subunit of the NMDA receptor, potentiates the antidepressant-like effects of certain antidepressant drugs in the forced swim test in mice. Metabolic brain disease 2016; 31: 803–814.

Abdallah CG, Averill LA, Collins KA et al.: Ketamine treatment and global brain connectivity in major depression. Neuropsychopharmacology 2017;42:1210–1219.,

Kotlińska-Lemieszek A, Łuczak J, Bączyk E: Miejsce ketaminy w leczeniu bólu nowotworowego. Polska Medycyna Paliatywna 2003; 1: 61–70.



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