ReviewCNS spectrums2016
Ameliorating treatment-refractory depression with intranasal ketamine: potential NMDA receptor actions in the pain circuitry representing mental anguish.
Review in CNS spectrums, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 29 citations in OpenAlex.
- Perioperative Adjunctive Esketamine for Postpartum Depression Among Women Undergoing Elective Cesarean Delivery: A Randomized Clinical Trial.JAMA network open · 2024Trial
- Stress and Inflammation Target Dorsolateral Prefrontal Cortex Function: Neural Mechanisms Underlying Weakened Cognitive Control.Biological psychiatry · 2025Review
- Contrasting patterns of extrasynaptic NMDAR-GluN2B expression in macaque subgenual cingulate and dorsolateral prefrontal cortices.Frontiers in neuroanatomy · 2025Article
- The Aversive Lens: Stress effects on the prefrontal-cingulate cortical pathways that regulate emotion.Neuroscience and biobehavioral reviews · 2023Review
- Antidepressant mechanisms of ketamine: a review of actions with relevance to treatment-resistance and neuroprogression.Frontiers in neuroscience · 2023Review
- Recommendations for selection and adaptation of rating scales for clinical studies of rapid-acting antidepressants.Frontiers in psychiatry · 2023Review
- Ketamine and esketamine in suicidal thoughts and behaviors: a systematic review.Therapeutic advances in psychopharmacology · 2023Review
- Efficacy of ketamine for comorbid depression and acute or chronic pain: A systematic review.Frontiers in pain research (Lausanne, Switzerland) · 2022Review
- NMDAR Neurotransmission Needed for Persistent Neuronal Firing: Potential Roles in Mental Disorders.Frontiers in psychiatry · 2021Review
- Guanfacine's mechanism of action in treating prefrontal cortical disorders: Successful translation across species.Neurobiology of learning and memory · 2020Review
- Serial Prefrontal Pathways Are Positioned to Balance Cognition and Emotion in Primates.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2020Article
- Ketamine in Major Depressive Disorder: Mechanisms and Future Perspectives.Psychiatry investigation · 2020Article
- Emotion Regulation Using Virtual Environments and Real-Time fMRI Neurofeedback.Frontiers in neurology · 2018Article
- Ketamine and pharmacological imaging: use of functional magnetic resonance imaging to evaluate mechanisms of action.Behavioural pharmacology · 2017Review
- Risks Associated with Misuse of Ketamine as a Rapid-Acting Antidepressant.Neuroscience bulletin · 2016Review
- Ketamine's Antidepressant Actions: Potential Mechanisms in the Primate Medial Prefrontal Circuits That Represent Aversive Experience.Biological psychiatry · 2016Article
- Targeting Prefrontal Cortical Systems for Drug Development: Potential Therapies for Cognitive Disorders.Annual review of pharmacology and toxicology · 2016Review
- Stress weakens prefrontal networks: molecular insults to higher cognition.Nature neuroscience · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
This article reviews the antidepressant actions of ketamine, an N-methyl-D-aspartame glutamate receptor (NMDAR) antagonist, and offers a potential neural mechanism for intranasal ketamine's ultra-rapid actions based on the key role of NMDAR in the nonhuman primate prefrontal cortex (PFC). Although intravenous ketamine infusions can lift mood within hours, the current review describes how intranasal ketamine administration can have ultra-rapid antidepressant effects, beginning within minutes (5-40 minutes) and lasting hours, but with repeated treatments needed for sustained antidepressant actions. Research in rodents suggests that increased synaptogenesis in PFC may contribute to the prolonged benefit of ketamine administration, beginning hours after administration. However, these data cannot explain the relief that occurs within minutes of intranasal ketamine delivery. We hypothesize that the ultra-rapid effects of intranasal administration in humans may be due to ketamine blocking the NMDAR circuits that generate the emotional representations of pain (eg, Brodmann Areas 24 and 25, insular cortex), cortical areas that can be overactive in depression and which sit above the nasal epithelium. In contrast, NMDAR blockade in the dorsolateral PFC following systemic administration of ketamine may contribute to cognitive deficits. This novel view may help to explain how intravenous ketamine can treat the symptoms of depression yet worsen the symptoms of schizophrenia.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.