Ketamine for a Boost of Neural Plasticity: How, but Also When?

Abstract

Major depressive disorder affects millions of people and leads to debilitating symptoms. Although conventional antidepressants have been available and are often beneficial, they have several limitations, including a slow onset of action and an inadequate response for a substantial fraction of patients. Recently, ketamine—primarily a noncompetitive NMDA receptor antagonist, among other actions—was approved as a novel treatment for treatment-resistant depression and suicidal ideation. This was an exciting development because ketamine can relieve depressive symptoms rapidly and with sustained effect.