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Ketamine Therapy and its Mechanism of Action
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Ketamine Therapy and its Mechanism of Action

There have been several clinical trials in which single low dosage (0.5mg/kg) of intravenous Ketamine (IV) is used. As per the results, ketamine successfully yielded almost 70% response rate in individuals suffering from treatment-resistant depression. The variable duration of effectiveness seems to be related to different factors such as gender, age, depression duration, and comorbidities.

So how does Ketamine IV infusion work?

Ketamine is a receptor agonist, ionotropic glutamatergic N-methyl-d-aspartate – NMDA that has been used for anesthesia. But it is also prescribed (off-label) for the treatment of chronic pain. Ketamine set off synaptic plasticity by stimulating brain-derived neurotrophic aspect.

Research shows that as the NMDA receptor is blocked by ketamine, it stimulates a signal change in the [α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid] – AMPA receptors, increasing the flow of AMPA. The multistep mechanism of ketamine is somewhat ‘one-two punch’ for the receptors that activate the cascade of neuroplastic modifications in the brain cells. These modifications eventually help in the formation of new synapses and new neural membranes.

In responses to ketamine and classical antidepressants, BDNF also plays a major role in mediating synaptic plasticity. However, in comparison to the standard antidepressant, plasticity occurs instantly i.e. in just a few hours after the administration of ketamine.

This mechanism of action correlates with the instant effects of an antidepressant. But this is not something that is observed with traditional antidepressants.

Nevertheless, ketamine effects rapidly that it can be a clinical treatment on its own terms. While some patients get a permanent solution with ketamine therapy others may need a more scheduled treatment in the case of reoccurring symptoms.

However, the treatment of chronic depression with ketamine therapy should only be performed by a reputed and experienced psychiatrist. After the entire ketamine story is yet to be finalized and there are some ongoing researches focusing on addressing unsolved aspects of this treatment.

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