Bridging Rapid and Sustained Antidepressant Effects of Ketamine
Open accessAbstract
Acute administration of (R,S)-ketamine (ketamine) produces rapid antidepressant effects that in some patients can be sustained for several days to more than a week. Ketamine blocks N-methyl-d-asparate (NMDA) receptors (NMDARs) to elicit specific downstream signaling that induces a novel form of synaptic plasticity in the hippocampus that has been linked to the rapid antidepressant action. These signaling events lead to subsequent downstream transcriptional changes that are involved in the sustained antidepressant effects. Here we review how ketamine triggers this intracellular signaling pathway to mediate synaptic plasticity which underlies the rapid antidepressant effects and links it to downstream signaling and the sustained antidepressant effects.
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Ketamine impacts neuroplasticity, including through BDNF, in both a rapid and sustained manner.
“Thus, ketamine impacts neuroplasticity, including through BDNF, in both a rapid and sustained manner [18,19,77]”
From Variations in BDNF and Their Role in the Neurotrophic Antidepressant Mechanisms of Ketamine and Esketamine: A Review (2024) · cites this paper as [77]
Experimental — accuracy not yet measuredKetamine's fast and lasting antidepressant effects probably arise from different mechanisms: an initial glutamate surge sets off longer-term neuroplastic changes.
“Distinct mechanisms of action likely underlie ketamine’s rapid versus sustained antidepressant effects, with acute increases in glutamatergic transmission triggering sustained increases in downstream processes underlying neuroplasticity, as reviewed by Kim et al. [115].”
From Beyond the serotonin deficit hypothesis: Communicating a neuroplasticity framework of major depressive disorder (2024) · cites this paper as [115]
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Rapid homeostatic plasticity and neuropsychiatric therapeutics
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Page, C. E., Epperson, C. N., Novick, A. M., Duffy, K. A., & Thompson, S. M. (2024) · Molecular Psychiatry · doi:10.1038/s41380-024-02625-2 · Cited by 80 · see citing works
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From psychache to neuroplasticity: A unified rescue-repair model of Ketamine’s anti-suicidal action
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Synaptic Plasticity—Intrinsic Excitability and Antidepressant Discovery
Tanaka, M. (2026) · Biomedicines · doi:10.3390/biomedicines14061265
- Authors
- Kim, J.-W., Suzuki, K., Kavalali, E. T., & Monteggia, L. M.
- Affiliations
- Vanderbilt University (US)
- Tokyo University of Science (JP)
- Corresponding author
- Monteggia, Lisa M.
- Venue
- Trends in Molecular Medicine
- Publisher
- Elsevier BV
- Published
- 2023-05
- Volume
- 29
- Issue
- 5
- Pages
- 364-375
- ISSN
- 1471-4914 (ISSN-L)
- PMC
- PMC10101916
- OpenAlex
- W4323826024
- Cited by
- 59
- References
- 104
- Citations by year
- 2026: 16 · 2025: 19 · 2024: 13 · 2023: 10
- FWCI
- 2.11
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Trends in Molecular Medicine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Ministry of Food and Drug Safety (21153MFDS601)
- National Institutes of Health
- NIMH (MH066198, MH070727, MH081060)
- NARSAD (27733, 30254)
- Japan Society for the Promotion of Science (22K20697)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neuropharmacology Research
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- ketamine, rapid antidepressant effects, NMDA receptor antagonism, synaptic plasticity, hippocampus, intracellular signaling, gene expression changes, depression
- MeSH terms
- Antidepressive Agents, Depression, Hippocampus, Humans, Ketamine, Signal Transduction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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