Cited by 86Treatment of Major DepressionTryptophan and brain disordersElectroconvulsive Therapy Studies

D-serine plasma concentration is a potential biomarker of (R,S)-ketamine antidepressant response in subjects with treatment-resistant depression

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Moaddel, Ruin, Luckenbaugh, David A., Xie, Ying, Villaseñor, Alma, Brutsche, Nancy E., Machado-Vieira, Rodrigo, Ramamoorthy, Anuradha, Lorenzo, Maria Paz +6 more·2015·Psychopharmacology

Abstract

Rationale (R,S)-ketamine is a rapid and effective antidepressant drug that produces a response in two thirds of patients with treatment-resistant depression (TRD). The underlying biochemical differences between a (R,S)-ketamine responder (KET-R) and non-responder (KET-NR) have not been definitively identified but may involve serine metabolism. Objectives The aim of the study was to examine the relationship between baseline plasma concentrations of D-serine and its precursor L-serine and antidepressant response to (R,S)-ketamine in TRD patients. Methods Plasma samples were obtained from 21 TRD patients at baseline, 60 min before initiation of the (R,S)-ketamine infusion. Patients were classified as KET-Rs (n = 8) or KET-NRs (n = 13) based upon the difference in Montgomery-Åsberg Depression Rating Scale (MADRS) scores at baseline and 230 min after infusion, with response defined as a ≥50 % decrease in MADRS score. The plasma concentrations of D-serine and L-serine were determined using liquid chromatography-mass spectrometry. Results Baseline D-serine plasma concentrations were significantly lower in KET-Rs (3.02 ± 0.21 μM) than in KET-NRs (4.68 ± 0.81 μM), p < 0.001. A significant relationship between baseline D-serine plasma concentrations and percent change in MADRS at 230 min was determined using a Pearson correlation, r = 0.77, p < 0.001, with baseline D-serine explaining 60 % of the variance in (R,S)-ketamine response. The baseline concentrations of L-serine (L-Ser) in KET-Rs were also significantly lower than those measured in KET-NRs (66.2 ± 9.6 μM vs 242.9 ± 5.6 μM, respectively; p < 0.0001). Conclusions The results demonstrate that the baseline D-serine plasma concentrations were significantly lower in KET-Rs than in KET-NRs and suggest that this variable can be used to predict an antidepressant response following (R,S)-ketamine administration.

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  • Ketamine inhibits transport of D-serine, ketamine metabolites decrease intracellular concentrations of D-serine in PC-12 cells, and plasma D-serine levels predict a response to the antidepressant effects of ketamine.

    “In this regard, it is interesting that ketamine inhibits transport of D-serine,124 ketamine metabolites decrease intracellular concentrations of D-serine in PC-12 cells,125 and that plasma D-serine levels predict a response to the antidepressant effects of ketamine.126,127”

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Authors
Moaddel, R., Luckenbaugh, D. A., Xie, Y., Villaseñor, A., Brutsche, N. E., Machado-Vieira, R., Ramamoorthy, A., Lorenzo, M. P., Garcia, A., Bernier, M., Torjman, M. C., Barbas, C., Zarate, C. A., & Wainer, I. W.
Affiliations
  • National Institutes of Health (US)
  • Universidad San Pablo CEU (ES)
  • Cooper Medical School of Rowan University (US)
Corresponding author
Wainer, Irving W.
Venue
Psychopharmacology
Published
2014-07-24
Volume
232
Issue
2
Pages
399-409
ISSN
  • 0033-3158 (ISSN-L)
  • 1432-2072
OpenAlex
W1972478979
Cited by
86
References
38
Citations by year
2026: 5 · 2025: 8 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 8 · 2020: 9 · 2019: 3 · 2018: 7 · 2017: 11 · 2016: 5 · 2015: 12 · 2014: 3
FWCI
7.53
Type
journal article
Language
en
Open access
Locations
  • Psychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • CEU Repositorio Institucional (Fundación Universitaria San Pablo CEU) (submittedVersion, cc-by-nc-nd)
Funders
National Institutes of Health (Z99 AG999999)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords
D-serine, L-serine, treatment-resistant depression, antidepressant response prediction, biomarkers, serine metabolism, plasma concentration, rapid-acting antidepressants
MeSH terms
Adult, Antidepressive Agents, Chromatography, Liquid, Female, Humans, Infusions, Intravenous, Ketamine, Male, Middle Aged, Serine, Biomarkers, Tandem Mass Spectrometry, Depressive Disorder, Treatment-Resistant

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