Predictable Biomarkers for Rapid-Acting Antidepressant Response to Ketamine

Tan, Yunfei; Hashimoto, Kenji

doi:10.1007/978-3-030-79790-4_3

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“…It is widely recognized that ( R,S )-ketamine causes cognitive impairment in healthy subjects [ 12 , 13 , 35 ]. However, increasing evidence suggests that ( R,S )-ketamine may improve cognitive impairment in patients with mood disorders such as MDD and BD [ 36 , 37 ]. In the current article, the author reviewed the therapeutic potential of ( R,S )-ketamine and its enantiomer ( R )-ketamine (or arketamine) for cognitive impairment in neuropsychiatric disorders.…”

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confidence: 99%

Arketamine for cognitive impairment in psychiatric disorders

Hashimoto

2023

Eur Arch Psychiatry Clin Neurosci

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Cognitive impairment has been observed in patients with various psychiatric disorders, including schizophrenia, major depressive disorder (MDD), and bipolar disorder (BD). Although modern therapeutic drugs can improve certain symptoms (i.e., psychosis, depression) in these patients, these drugs have not been found to improve cognitive impairment. The N-methyl-D-aspartate receptor antagonist (R,S)-ketamine has attracted attention as a rapidly acting antidepressant. In addition to its robust antidepressant effects, (R,S)-ketamine has been suggested to improve cognitive impairment in patients with MDD and BD, despite causing cognitive impairment in healthy control subjects. (R,S)-ketamine is a racemic mixture of equal amounts of (R)-ketamine (or arketamine) and (S)-ketamine (or esketamine). Arketamine has been found to have more potent antidepressant-like actions than esketamine in rodents. Interestingly, arketamine, but not esketamine, has been suggested to improve phencyclidine-induced cognitive deficits in mice. Furthermore, arketamine has been suggested to ameliorate cognitive deficits in rodent offspring after maternal immune activation. In the current article, it is proposed that arketamine has therapeutic potential for treating cognitive impairment in patients with psychiatric disorders. Additionally, the potential role of the gut–microbiome–brain axis in cognitive impairment in psychiatric disorders is discussed.

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