Kavalali Ege T, Monteggia Lisa M
Department of Pharmacology and the Vanderbilt Brain Institute, Vanderbilt University, 465 21st Avenue South, Suite 7130 Medical Building III, Nashville, TN, 37240-7933, USA.
Eur Arch Psychiatry Clin Neurosci. 2024 Sep 29. doi: 10.1007/s00406-024-01898-6.
The discovery of ketamine's rapid antidepressant action has generated intense interest in the field of neuropsychiatry. This discovery demonstrated that to alleviate the symptoms of depression, treatments do not need to elicit substantive alterations in neuronal circuitry or trigger neurogenesis, but rather drive synaptic plasticity mechanisms to compensate for the underlying pathophysiology. The possibility of a rapidly induced antidepressant effect makes therapeutic pursuit of fast-acting neuropsychiatric medications against mood disorders plausible. In the meantime, the accumulating clinical as well as preclinical observations raise critical questions on the nature of the specific synaptic plasticity events that mediate these rapid antidepressant effects. This work has triggered the current growing interest in alternative psychoactive compounds that are thought to have similar properties to ketamine and its action. This review covers our insight into these questions based on the work our group has conducted on this topic in the last decade.
氯胺酮快速抗抑郁作用的发现引起了神经精神病学领域的浓厚兴趣。这一发现表明,为缓解抑郁症状,治疗无需引起神经元回路的实质性改变或触发神经发生,而是驱动突触可塑性机制来补偿潜在的病理生理学。快速诱导抗抑郁作用的可能性使得研发针对情绪障碍的速效神经精神药物成为一种可行的治疗追求。与此同时,越来越多的临床和临床前观察结果对介导这些快速抗抑郁作用的特定突触可塑性事件的本质提出了关键问题。这项工作引发了当前人们对其他精神活性化合物的日益浓厚的兴趣,这些化合物被认为具有与氯胺酮及其作用相似的特性。本综述基于我们小组在过去十年中关于该主题的研究工作,阐述了我们对这些问题的见解。