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超越氯胺酮:用于治疗抑郁症的新型谷氨酸能化合物

Advancing past ketamine: emerging glutamatergic compounds for the treatment of depression.

作者信息

Freudenberg Florian, Reif-Leonhard Christine, Reif Andreas

机构信息

Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany.

Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, 60596, Frankfurt Am Main, Germany.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2024 Aug 29. doi: 10.1007/s00406-024-01875-z.


DOI:10.1007/s00406-024-01875-z
PMID:39207462
Abstract

Changes in glutamatergic neuroplasticity has been proposed as one of the core mechanisms underlying the pathophysiology of depression. In consequence components of the glutamatergic synapse have been explored as potential targets for antidepressant treatment. The rapid antidepressant effect of the NMDA receptor antagonist ketamine and subsequent approval of its S-enantiomer (i.e. esketamine), have set the precedent for investigation into other glutamatergic rapid acting antidepressants (RAADs). In this review, we discuss the potential of the different glutamatergic targets for antidepressant treatment. We describe important clinical outcomes of several key molecules targeting components of the glutamatergic synapse and their applicability as RAADs. Specifically, here we focus on substances beyond (es)ketamine, for which meaningful data from clinical trials are available, including arketamine, esmethadone, nitrous oxide and other glutamate receptor modulators. Molecules only successful in preclinical settings and case reports/series are only marginally discussed. With this review, we aim underscore the critical role of glutamatergic modulation in advancing antidepressant therapy, thereby possibly enhancing clinical outcomes but also to reducing the burden of depression through faster therapeutic effects.

摘要

谷氨酸能神经可塑性的变化被认为是抑郁症病理生理学的核心机制之一。因此,谷氨酸能突触的组成部分已被探索为抗抑郁治疗的潜在靶点。NMDA受体拮抗剂氯胺酮的快速抗抑郁作用及其S-对映体(即艾司氯胺酮)随后的获批,为研究其他谷氨酸能速效抗抑郁药(RAADs)开创了先例。在本综述中,我们讨论了不同谷氨酸能靶点用于抗抑郁治疗的潜力。我们描述了几种针对谷氨酸能突触组成部分的关键分子的重要临床结果及其作为RAADs的适用性。具体而言,我们在此关注(艾司)氯胺酮以外的物质,对于这些物质,有来自临床试验的有意义的数据,包括阿氯胺酮、艾司美沙酮、一氧化二氮和其他谷氨酸受体调节剂。仅在临床前研究以及病例报告/系列中取得成功的分子仅作了少量讨论。通过本综述,我们旨在强调谷氨酸能调节在推进抗抑郁治疗中的关键作用,从而可能改善临床结果,同时通过更快的治疗效果减轻抑郁症的负担。

相似文献

[1]
Advancing past ketamine: emerging glutamatergic compounds for the treatment of depression.

Eur Arch Psychiatry Clin Neurosci. 2024-8-29

[2]
The role of glutamatergic modulation in the mechanism of action of ketamine, a prototype rapid-acting antidepressant drug.

Pharmacol Rep. 2018-2-9

[3]
Arketamine, a new rapid-acting antidepressant: A historical review and future directions.

Neuropharmacology. 2022-11-1

[4]
Molecular mechanisms underlying the antidepressant actions of arketamine: beyond the NMDA receptor.

Mol Psychiatry. 2022-1

[5]
[Rapid-acting antidepressants-neurobiological mechanisms of action].

Nervenarzt. 2022-3

[6]
An Update on Glutamatergic System in Suicidal Depression and on the Role of Esketamine.

Curr Top Med Chem. 2020

[7]
Roles of glutamate signaling in preclinical and/or mechanistic models of depression.

Pharmacol Biochem Behav. 2011-4-21

[8]
Rapid-acting antidepressant ketamine, its metabolites and other candidates: A historical overview and future perspective.

Psychiatry Clin Neurosci. 2019-7-11

[9]
NMDA receptors as therapeutic targets for depression treatment: Evidence from clinical to basic research.

Neuropharmacology. 2023-3-1

[10]
Targeting metabotropic glutamate receptors for rapid-acting antidepressant drug discovery.

Expert Opin Drug Discov. 2021-2

引用本文的文献

[1]
Esketamine alleviates depressive-like behavior in mice via modulation of the microbiota-gut-brain axis and amino acid metabolism.

BMC Microbiol. 2025-9-1

[2]
Antidepressant Effects of Nitrous Oxide in Major Depressive Disorder: A Phase 2b Randomized Clinical Trial.

Biol Psychiatry Glob Open Sci. 2025-4-15

[3]
Arketamine: a scoping review of its use in humans.

Eur Arch Psychiatry Clin Neurosci. 2024-12-16

本文引用的文献

[1]
The boon and bane of nitrous oxide.

Eur Arch Psychiatry Clin Neurosci. 2024-4-13

[2]
Ketamine and the neurobiology of depression: Toward next-generation rapid-acting antidepressant treatments.

Proc Natl Acad Sci U S A. 2023-12-5

[3]
Psychedelics for treatment resistant depression: are they game changers?

Expert Opin Pharmacother. 2023

[4]
The Potential of Scopolamine as an Antidepressant in Major Depressive Disorder: A Systematic Review of Randomized Controlled Trials.

Biomedicines. 2023-9-26

[5]
Psilocybin-assisted therapy for depression: A systematic review and meta-analysis.

Psychiatry Res. 2023-11

[6]
MIJ821 (onfasprodil) in healthy volunteers: First-in-human, randomized, placebo-controlled study (single ascending dose and repeated intravenous dose).

Clin Transl Sci. 2023-11

[7]
Esketamine Nasal Spray versus Quetiapine for Treatment-Resistant Depression.

N Engl J Med. 2023-10-5

[8]
Does the intensity of dissociation predict antidepressant effects 24 hours after infusion of racemic ketamine and esketamine in treatment-resistant depression? A secondary analysis from a randomized controlled trial.

Trends Psychiatry Psychother. 2023-9-17

[9]
Treatment-resistant depression: definition, prevalence, detection, management, and investigational interventions.

World Psychiatry. 2023-10

[10]
NRX-101 (D-cycloserine plus lurasidone) vs. lurasidone for the maintenance of initial stabilization after ketamine in patients with severe bipolar depression with acute suicidal ideation and behavior: a randomized prospective phase 2 trial.

Int J Bipolar Disord. 2023-8-13

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