Activity-dependent brain-derived neurotrophic factor signaling is required for the antidepressant actions of (2 R ,6 R )-hydroxynorketamine
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Significance: A metabolite of ketamine, (2 R ,6 R )-hydroxynorketamine [(2 R ,6 R )-HNK], produces rapid and sustained antidepressant effects in animal models but without the side effects of ketamine. Notably, (2 R ,6 R )-HNK does not block the NMDA receptor, the primary target of ketamine. Here, we demonstrate that the antidepressant effects of (2 R ,6 R )-HNK require activity dependent release of BDNF that is mediated by stimulation of voltage-dependent Ca 2+ channels. Importantly, increased BDNF release leads to activation of downstream TrkB and mechanistic target of rapamycin complex 1 signaling that increases synaptic function of pyramidal neurons in the medial prefrontal cortex. Stimulation of BDNF release and increased synaptic function block or reverse the detrimental effects of stress and depression and thereby underlie the antidepressant actions of (2 R ,6 R )-HNK.
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Hydroxynorketamine (HNK) rapidly induces synaptogenesis and antidepressant-like effects without psychotomimetic effects in animal models.
“hydroxynorketamine (HNK - a metabolite of ketamine which rapidly induces synaptogenesis and antidepressant-like effects without psychotomimetic effects in animal models) 44”
From Imaging the effect of ketamine on synaptic density (SV2A) in the living brain (2022) · cites this paper as [44]
The Introduction and Discussion describe (2R,6R)-HNK as a ketamine metabolite with rapid antidepressant effects in rodent models and without ketamine’s side-effect profile. But the paper does not establish rapid synaptogenesis: the Results report increased synaptic function without an increase in spine density, and the Discussion says a synaptogenic response may be absent or below detection. The claim therefore overstates the synaptogenesis finding. (LLM, conf=0.90)
Experimental — accuracy not yet measured(2R,6R)-HNK at 30 mg/kg intraperitoneally produced antidepressant-like effects in mice in the forced swim test and female urine sniffing test 24 hours after treatment.
“(2R,6R)-HNK (30 mg/kg i.p.) produced antidepressant-like effects in mice tested in the forced swim test and female urine sniffing test 24 hours post-treatment”
From Mechanisms of ketamine and its metabolites as antidepressants (2022) · cites this paper as Fukumoto et al., 2019
The effects of (2R,6R)-HNK in the forced swim test and novelty suppressed feeding test were blocked in mice carrying the BDNF Val66Met allele, including heterozygous Val/Met and homozygous Met/Met mice.
“The effects of (2R,6R)-HNK in the forced swim test and novelty suppressed feeding were blocked in mice containing the BDNF Val66Met allele (heterozygous Val/Met and homozygous Met/Met mice) (Fukumoto et al., 2019).”
From Mechanisms of ketamine and its metabolites as antidepressants (2022) · cites this paper as Fukumoto et al., 2019
The literature on the antidepressant effects of 2R,6R-HNK is controversial, with several contradictory reports.
“However, the literature on the antidepressant effects of 2R,6R-HNK is controversial, with several contradictory reports.41,48–52”
From Ketamine as an antidepressant: Overview of its mechanisms of action and potential predictive biomarkers (2020) · cites this paper as [49]
mTORC1 signaling is necessary and may be sufficient to produce rapid synaptic and antidepressant behavioral responses.
“These studies indicate that mTORC1 signaling is necessary and may be sufficient to produce rapid synaptic and antidepressant behavioral responses.”
From Sestrin modulator NV-5138 produces rapid antidepressant effects via direct mTORC1 activation (2019) · cites this paper as [10]
Infusion of rapamycin alone into the mPFC has no effect on these behaviors.
“Previous studies demonstrate that infusion of rapamycin alone into the mPFC has no effect on these behaviors (7, 8, 10, 12).”
From Sestrin modulator NV-5138 produces rapid antidepressant effects via direct mTORC1 activation (2019) · cites this paper as [10]
Ketamine's actions occur via a burst of glutamate and require AMPA receptor activation.
“While the effects of NV-5138 and ketamine converge on mTORC1 signaling, the actions of ketamine occur via a burst of glutamate and require AMPA receptor activation, based on evidence that pretreatment with an AMPA receptor antagonist (NBQX) blocks the antidepressant actions of ketamine as well as other rapid-acting agents (7, 10, 12, 39, 40).”
From Sestrin modulator NV-5138 produces rapid antidepressant effects via direct mTORC1 activation (2019) · cites this paper as [10]
Pretreatment with an AMPA receptor antagonist (NBQX) blocks the antidepressant actions of ketamine and other rapid-acting agents.
“While the effects of NV-5138 and ketamine converge on mTORC1 signaling, the actions of ketamine occur via a burst of glutamate and require AMPA receptor activation, based on evidence that pretreatment with an AMPA receptor antagonist (NBQX) blocks the antidepressant actions of ketamine as well as other rapid-acting agents (7, 10, 12, 39, 40).”
From Sestrin modulator NV-5138 produces rapid antidepressant effects via direct mTORC1 activation (2019) · cites this paper as [10]
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Sestrin modulator NV-5138 produces rapid antidepressant effects via direct mTORC1 activation
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Self-citationKetamine and the Future of Rapid-Acting Antidepressants
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“In a parallel [(11)C]UCB-J PET study in rhesus macaques, we examined the effects of both ketamine and hydroxynorketamine (HNK—a metabolite of ketamine which rapidly induces synaptogenesis and antidepressant-like effects without psychotomimetic effects in animal models) [44], on synaptic density at 24 h, 1 week and 4–6…”
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Ketamine Metabolite (2<i>R</i>,6<i>R</i>)-Hydroxynorketamine Interacts with μ and κ Opioid Receptors
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Self-citationNV-5138 as a fast-acting antidepressant via direct activation of mTORC1 signaling
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- Authors
- Fukumoto, K., Fogaça, M. V., Liu, R.-J., Duman, C., Kato, T., Li, X.-Y., & Duman, R. S.
- Affiliations
- Taisho Pharmaceutical (Japan) (JP)
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06520;
- Yale University (US)
- Sumitomo Dainippon Pharma (Japan) (JP)
- Corresponding author
- Duman, Ronald S.
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2018-12-17
- Volume
- 116
- Issue
- 1
- Pages
- 297-302
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC6320534
- OpenAlex
- W2903713826
- Cited by
- 188
- References
- 59
- Citations by year
- 2026: 14 · 2025: 13 · 2024: 22 · 2023: 22 · 2022: 32 · 2021: 37 · 2020: 24 · 2019: 24
- FWCI
- 13.71
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- HHS | NIH | National Institute of Mental Health (MH093897, MH105910)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neuropharmacology Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- (2R,6R)-hydroxynorketamine, ketamine metabolites, antidepressant effects, brain-derived neurotrophic factor, voltage-gated calcium channels, TrkB signaling, mTORC1 signaling, medial prefrontal cortex, pyramidal neurons, synaptic function, stress and depression, depression
- MeSH terms
- Mechanistic Target of Rapamycin Complex 1, Animals, Antidepressive Agents, Cells, Cultured, Depression, Disease Models, Animal, Dose-Response Relationship, Drug, Ketamine, Synaptic Transmission, Neurons, Signal Transduction, Brain-Derived Neurotrophic Factor
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