Gębik Bronisław, Bliźniewska-Kowalska Katarzyna, Gałecki Piotr
Klinika Psychiatrii Dorosłych 91-229 Łódź, ul. Aleksandrowska 159.
Psychiatr Pol. 2025 Jun 2:1-19. doi: 10.12740/PP/OnlineFirst/202128.
Since the year 2000, ketamine and its enantiomers have been studied for their antidepressant effects. This paper will briefly summarise the journey of ketamine from an anaesthetic to an antidepressant. The text will present the key mechanisms of its action, as well as the actions of its metabolites. The aim of this article is to describe the role of specific groups of receptors in activation of important metabolic pathways and in production of factors such as mammalian target of rapamycin kinase (mTOR) and brain-derived neurotrophic factor (BDNF), in order to comprehensively present a potential link between ketamine, ketamine's enantiomers and its metabolites with terms such as neuroplasticity and antidepressant action. Another important part of this article is a summary of arguments for and against importance of specific mechanisms of ketamine action and to compare (S) and (R)-ketamine's potential to act as an antidepressant. This article may be particularly helpful for researchers in determining further research directions and serve as a summary of the current state of knowledge regarding the mechanisms of ketamine's action and the latest therapeutic possibilities in the treatment of affective disorders.
自2000年以来，氯胺酮及其对映体的抗抑郁作用就一直受到研究。本文将简要概述氯胺酮从麻醉剂到抗抑郁药的历程。文中将介绍其作用的关键机制以及代谢产物的作用。本文的目的是描述特定受体组在激活重要代谢途径以及产生诸如雷帕霉素激酶哺乳动物靶点（mTOR）和脑源性神经营养因子（BDNF）等因子过程中的作用，以便全面呈现氯胺酮、氯胺酮对映体及其代谢产物与神经可塑性和抗抑郁作用等术语之间的潜在联系。本文的另一个重要部分是总结支持和反对氯胺酮作用特定机制重要性的观点，并比较（S）-氯胺酮和（R）-氯胺酮作为抗抑郁药的潜力。本文对于研究人员确定进一步的研究方向可能特别有帮助，并可作为关于氯胺酮作用机制和情感障碍治疗最新治疗可能性的当前知识状态的总结。
