Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary.
NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary.
Int J Neuropsychopharmacol. 2023 Sep 25;26(9):618-626. doi: 10.1093/ijnp/pyad050.
Racemic ketamine consists of two enantiomers, namely (R)-ketamine and (S)-ketamine, with distinguishable pharmacological properties. Both enantiomers have been reported to show rapid antidepressant effects in rodents. Currently, the (S)-enantiomer has been approved for the treatment of major depression, whereas (R)-ketamine failed to show antidepressant effect in recent clinical studies. Major depressive disorder is frequently characterized by disinhibition of rapid eye movement (REM) sleep and disruption of non-REM (NREM) sleep. Racemic ketamine and most conventional antidepressants affect these parameters. However, it remains largely unknown which enantiomer is responsible for these effects.
Here, we compared acute effects of the two ketamine enantiomers (15 mg/kg i.p.) on different sleep-wake stages in freely moving, EEG-equipped rats. We also evaluated the antidepressant-like activity of the enantiomers in a chronic restraint stress model of depression.
(S)-ketamine but not (R)-ketamine increased REM sleep latency and decreased REM sleep time at 2 and 3 hours, and increased electroencephalogram delta power during NREM sleep. In addition, only (S)-ketamine increased wakefulness and decreased NREM sleep in the first 2 hours. In the forced swimming test, only (S)-ketamine decreased the immobility time of chronically stressed rats.
Effects of the two ketamine enantiomers on rat sleep-wake architecture and behavior are markedly different when administered in the same dose. (S)-ketamine remarkably affects the sleep-wake cycle and very likely sleep-related neuroplasticity, which may be relevant for its antidepressant efficacy. Our results regarding (R)-ketamine's lack of effect on vigilance and behavior are in line with recent clinical studies.
消旋氯胺酮由两种对映异构体组成,即(R)-氯胺酮和(S)-氯胺酮,具有不同的药理学特性。两种对映异构体均已被报道在啮齿动物中具有快速抗抑郁作用。目前,(S)-对映异构体已被批准用于治疗重度抑郁症,而(R)-氯胺酮在最近的临床研究中未能显示出抗抑郁作用。重度抑郁症常表现为快速眼动(REM)睡眠抑制和非快速眼动(NREM)睡眠中断。消旋氯胺酮和大多数传统抗抑郁药都会影响这些参数。然而,哪种对映异构体负责这些影响在很大程度上仍不清楚。
在这里,我们比较了两种氯胺酮对映异构体(15mg/kg,ip)对自由活动、脑电图装备的大鼠不同睡眠-觉醒阶段的急性影响。我们还评估了这些对映异构体在慢性束缚应激抑郁模型中的抗抑郁样活性。
(S)-氯胺酮而非(R)-氯胺酮在 2 和 3 小时时增加 REM 睡眠潜伏期并减少 REM 睡眠时间,并增加 NREM 睡眠期间的脑电图 delta 功率。此外,只有(S)-氯胺酮在头 2 小时增加觉醒并减少 NREM 睡眠。在强迫游泳试验中,只有(S)-氯胺酮减少了慢性应激大鼠的不动时间。
当以相同剂量给药时,两种氯胺酮对映异构体对大鼠睡眠-觉醒结构和行为的影响明显不同。(S)-氯胺酮显著影响睡眠-觉醒周期,很可能与睡眠相关的神经可塑性有关,这可能与其抗抑郁疗效有关。我们关于(R)-氯胺酮对警觉性和行为没有影响的结果与最近的临床研究一致。