Ketamine as a Prototype of Next Antidepressant Generation

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Depression is the most common mental disorder worldwide and one of the top ten causes of morbidities and mortalities (Berton and Nestler, 2006; Nestler et al., 2002). 20% of world populations are affected by depression at anytime of their lives whereas 4% of men and 8% of women are affected by clinically significant depressive disorder. However depressive symptoms in general are much more common (Lehtinen, V and Joukamaa ,M 1994). While depression came the second on the list of the most disabling disorder when it is measured by years lived in disability, WHO predicted that it would be the 1st leading health problem within the next 20 years. (Leonard B.E and Cryan J.F). Unfortunately, the currently available antidepressants needs weeks to months to initiate its onset of action. Though, the percentage of responders during this period ranges from 30 to 60 % (Trivedi et al, 2006 ref). More recently, ketamine showed a rapid onset and sustained antidepressant activity, a turning point that can revolutionize antidepressant therapeutic strategies and outcome. This article will evaluate the efficacy of ketamine versus standard antidepressants and will highlight on ketamine potential as a prototype for new rapid acting antidepressant generation. In the early 20th century, depression therapeutic strategies ranged from invasive therapeutics like insulin coma therapy, chemical and electrical shock therapy to administration of some addictive chemicals like chloral hydrate, barbiturates, amphetamines and opiates (Lopez-Munoz & Alamo C, 2009). In 1950s, Ipronizide, which was previously used as anti-tuberculosis, was introduced as the first Mono-amino-oxidase inhibitor (MAOI) and the first antidepressant ever marketed. Then Imipramine was int... ... middle of paper ... ...levated-plus maze, and the social interaction test in Wistar rats. Depress Anxiety 5(1), pp 29−33. Simon G.E, Savarino J, Operkalski B, Wang P S, (2006), Suicide risk during antidepressant treatment. ,Am. J. Psychiatry.,163, pp 41-47. Trivedi MH , (2006), Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D implications for clinical practice. AmJ Psychiatry ,163(1): pp 28-40 Liu and aghanian 2008 Zarate C. A., Du J., Quiroz J., Gray N. A., Denicoff K., Singh J. B., et al. (2003). Regulation of cellular plasticity cascades in the pathophysiology and treatment of mood disorders: role of the glutamatergic system. Ann N Y Acad Sci 1003, 273−291. Zarate C, Singh J, Manji H.K (2006) Cellular Plasticity cascades: Targets for the developments of novel therapeutics for Bipolar disorder. , Biol. Psych. 59, pp 1006-1020.

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